Presented  in  honor  of 
Solon  Richard  Boynton  Sr. 


M.D. 


COLLEGE  OF   OSTEOPATHIC   PHYSICIANS 
AND  SURGEONS   •  LOS  ANGELES,  CALIFORNIA 


/fa 


HOMEOPATHIC    TREATMENT 


BY    B.     F.    JOSLIN,    M.D.,     L.L.D., 

FELLOW   OF   THE   ALBANY   MEDICAL   COLLEGE  ;     FELLOW   AND   CORRESPONDING 
MEMBER   OF    THE    HOMEOPATHIC    MEDICAL    COLLEGE   OF    PENNSYL- 
VANIA,   &C.,  &C. 


THIRD    EDITION,   WITH  ADDITIONS. 


N  E  W  -  T  0  B,  K  : 
PUBLISHED  BY  WILLIAM  RADDE,   No.  322  BROADWAY. 

PHILADELPHIA  :  RADEMACHER  &  SHEER. — BOSTON  :  OTIS  CLAPP.- 
LONDON  :  J.  EPPS,  112  GBEAT  RUSSELL-ST.,  BLOOMSBUBY.- 
MANCHESTER  :  HENHY  TURNER,  41  PICCADILLY. 

1804, 


Entered  according  to  Act  of  Congress,  in  ilio  year  ISM, 

liv    WILLIAM  RADOK, 

la  the  Clerk's  Office  of  tbe  District  Court  of  the  Southern  District  of 
New-York. 


HENRY  LUDWIU,  Prinitr, 


CONTENTS. 


Page 

PREFACE  AND  INTRODUCTION, V 

CHAP.  I. — NATURE  and  PATHOLOGY  of  Cholera. 

Characteristics  of  the  disease, 13 

Physiology  of  Respiration, 16 

Application  to  the  Pathology  of  Cholera, 18 

CHAP.   II. — .ETIOLOGY,  especially  of  the  Predisposing  or  occasion- 
al Causes. 

Preliminary  setiological  remarks, 30 

Atmospheric  heat, 32 

Becoming  chilled  by  cold  air,  or  bathing, 35 

The  Night  season, 37 

Depressing  passions,  fatigue,  fasting,  and  alcohol, 38 

Abstinence  from  animal  food, 40 

Oppression  of  the  digestive  organs  with  food, 43 

Crowded  or  insufficiently  Ventilated  Rooms, 44 

Neglect  of  personal  Cleanliness, 45 

Ungeneralized  facts, 46 

Recapitulation 48 

CHAP.  III. — DOCTRINE  OF  INFECTION. 


Error  of  the  prevalent  doctrine 

Indefiniteness  of  the  problem, 

Influence  of  Dilution, 

Influence  of  Dose 

Influence  of  susceptibility, .*  . . 

Routes  and  modes  in  which  the  Cholera  travels, , 


CONTENTS. 


Page 
CHAP.   IV. — HYGIENE  and  PROPHYLAXIS. 

Articles  hurtful  to  persons  taking  medicines, 61 

Rules  of  Regimen, 62 

Prophylactics, 65 

CHAP.   V. — HISTORY  OF  TREATMENT, 

Or  Statistical  proofs  of  the  success  of  Homoeopathy  in  Cholera,  67 

Preliminary  Remarks, 67 

The  Cholera  Epidemic  of  1831-32, 70 

"               "              1848-49 76 

"         in  1854, 97 

CHAP.  VI.— EAKLY  TREATMENT, 

Including  that  of  the  Premonitory  Symptoms,  and  of  the  dis- 
ease at  its  onset,  with  rules  for  the  general  management,  100 

Treatment  of  Premonitory  Symptoms,  &c., 100 

"           at  the  Commencement  of  Cholera, 102 

Rules  for  the  management  of  a  Cholera  patient, 108 

CHAP.  VII. — SYMPTOMS  and    TREATMENT  of  the  VARIETIES  of 
CHOLERA. 

Law  of  cure,  and  repetition  and  magnitude  of  doses, 109 

Symptoms  of  the  1st  variety,  Diarrhceic  Cholera, 113 

Treatment  of  Diarrhoeic  Cholera, 115 

Symptoms  of  the  2d  variety,  Gastric  Cholera, 116 

Treatment  of  Gastric  Cholera, 117 

Symptoms  of  the  3d  variety,  Spasmodic  Cholera, 117 

Treatment  of  Spasmodic  Cholera, 118 

Symptoms  of  the  4th  variety,  Dry  Cholera, 119 

Treatment  of  Dry  Cholera, 120 

Symptoms  of  the  5th  variety,  Acute  Cholera, 120 

Treatment  of  Acute  Cholera, 121 

Symptoms  of  the  6th  jariety,  Gastro- Enteric  Cholera, 122 

Treatment  of  Gastro-Enteric  Cholera 123 


CONTENTS. 


Page 

Symptoms  of  the  7th  variety,  Dysenteric  Cholera, 123 

Treatment  of  Dysenteric  Cholera, 125 

Symptoms  of  the  8th  variety,  Febrile  Cholera, 120 

Treatment  of  Febrile  Cholera, 126 

CHAP.  VIII. — SYMPTOMS  and   TREATMENT  of  the  STAGES  of 
CHOLERA. 

First  Stage,  stage  of  Invasion, 128 

O      *  O  * 

Second  Stage,  stage  of  full  Development, 129 

Third  Stage,  stage  of  Collapse, 130 

Fourth  Stage,  stage  of  Reaction, 131 

CHAP.    IX. — CASES  OF  CHOLERA  AND  CHOLEROID,  WITH  THEIR 
TREATMENT. 

Preliminary  Remarks, 134 

Cases  of  Choleroid  Disease, 138 

Cases  of  Diarrhoeic  Cholera, 144 

Cases  of  Gastric  Cholera, 160 

Cases  of  Spasmodic  Cholera 162 

Case  of  Dry  Cholera, 168 

Cases  of  Acute  Cholera, 170 

Case  of  Gastro-enteric  Cholera, 176 

Cases  of  Dysenteric  Cholera, 176 

Case  of  Febrile  Cholera, 179 

Case  of  Acute  Choleroid, 180 

CHAP.  X. — CHOLERA  REPERTORY  for  SYMPTOMS  AND  GROUPS, 
with  the  values  of  the  medicines  distinguished. 

Explanation  of  the  use  of  the  Repertory 181 

Mental  Symptoms,  Remedies  for, 183 

Head,  remedies  for  symptoms  relating  to  the, 184 

Eyes,  remedies  for  symptoms  relating  to  the, 184 

Face,  remedies  for  symptoms  relating  to  the, 185 

Tongue,  remedies  for  symptoms  relating  to  the, 186 


6  CONTENTS. 


Page 

Nausea  and  Thirst,  remedies  for, 187 

Vomiting,  remedies  for, 187 

Pains  at  the  Stomach,  remedies  for, 188 

Abdomen,  remedies  for  symptoms  relating  to  the, 189 

Diarrhoea,  remedies  for 190 

Urine,  remedies  for  symptoms  relating  to  the, 192 

Voice,  remedies  for  symptoms  relating  to  the 193 

Chest,  remedies  for  symptoms  relating  to  the, 193 

Superior  Extremities,  remedies,  &c 194 

Inferior  Extremities,  remedies,  &c 194 

Skin,  remedies  for  symptoms  relating  to  the, 195 

Perspiration  and  pulse,  remedies  relating  to, 197 

General  and  miscellaneous  symptoms,  remedies  for, 198 

CHAP.  XI. — AUXILIARY  CHOLERA  REPERTORY,  alto  adapted 
to  Vomiting,  Diarrhoea,  Cholera  Infantum  and  Dysentery. 

Explanation  of  the  use  of  the  Repertory, 199 

VOMITING  in  general, 200 

Character  of  the  vomiting, 200 

Its  causes  or  conditions, 202 

Its  Concomitants, 203 

Sensations  (pains,  &c.)  at  the  Stomach  and  Epigastrium,. . .  204 

DIARRHOEA  in  General, 206 

Color  of  the  Faeces 206 

Odor  of  the  Pieces, 207 

Their  Composition  and  Consistence, 207 

Causes  of  Diarrhoea, 208 

Concomitants  of  Diarrhoea, 209 

Groups  of  Diarrhoeic  Symptoms, 210 

Cholera  Infantum, 212 

Dysentery, 212 

Appendix  I., 215 

Appendix  II., 239 

Index, 245 


PREFACE    AND    INTRODUCTION, 


THE  favorable  reception  which  the  former  editions  of  this 
book  have  met  with,  has  encouraged  the  author  in  the  labor  of 
improving  it,  by  such  modifications  and  additions  as  were  sug- 
gested by  much  experience  in  the  epidemic  of  1849.  A  great 
amount  of  practical  matter  has  been  added,  including  a 
chapter  of  illustrative  cases,  in  1849  and  subsequent  years, 
to  the  present  month. 

The  book  has  been  used  as  a  guide  in  the  treatment  of  cho- 
lera, not  only  by  the  profession,  but  by  many  intelligent  lay- 
men. In  this  rapid  disease,  for  which  our  system  affords  the 
only  effectual  remedies,  many  families  in  localities  where  no 
homoeopathic  physician  can  be  soon  procured,  will  find  it  ne- 
cessary at  last  to  commence  the  treatment ;  and  some  mem- 
bers of  the  profession  who  had  been  previously  allopathic  will 
be  induced  to  prescribe  homoeopathically  for  cholera.  In 
consideration  of  the  wants  of  these  two  classes,  the  more  im- 
portant rules  of  treatment  are  given  in  a  more  particular  and 
elementary  form,  than  would  be  necessary  for  an  experienced 
homoeopathic  practitioner.  The  plain  rules  for  prevention, 
preliminary  treatment  and  nursing,  may  either  be  consulted 
directly  by  families,  or  employed  by  their  physician  as  a  safe 
and  convenient  basis  for  his  instructions. 

The  plan  offers  the  advantage  of  a  threefold  arrangement  of 
the  principal  medicines  ;  viz.,  with  reference,  1st,  to  the  varie- 


8  INTRODUCTION. 


ties  of  cholera ;  3d,  to  its  stages ;  and  3d,  to  its  symptoms 
as  arranged  in  repertories.  These  last  will  give  the  work  a 
permanent  value,  in  treating  the  more  frequent  complaints  of 
summer.  The  author  has  aimed  to  prepare  for  the  use  of 
practitioners  a  portable  treatise,  so  full  and  systematic  as  to 
enable  them  to  find  with  facility  the  remedy  for  every  curable 
case  of  this  disease. 

When  we  fail  in  our  attempts  at  homoeopathic  treatment,  in 
any  malady  which  is  curable  in  the  present  state  of  the  Mate- 
ria  Medica,  the  fault  is  not  in  the  law,  but  in  its  administra- 
tion. It  is  unjust  in  any  one,  to  impute  to  Homoeopathy  the 
disastrous  consequences  of  his  own  ignorance,  indolence  or 
haste,  and  unwise  to  attempt  by  allopathic  patches  to  strength- 
en his  practice  already  sufficiently  spurious,  and  conse- 
quently feeble.  Such  expedients  emasculate  his  Homoeopathy. 
None  will  learn  to  swim  who  depend  upon  bladders  under  the 
arms.  Eclecticism  will  be  less  resorted  to,  in  proportion  as 
the  character  of  the  profession  shall  become  more  elevated  in 
intellect,  industry  and  attainments,  and  physicians  shall  not 
consider  a  minute  study  of  the  case  and  of  the  Materia  Medica 
too  onerous,  when  human  life  depends  on  the  correctness  of  the 
prescription.  With  Hahnemann's  eulogium  of  the  profession, 
he  has  connected  a  requirement  and  an  injunction.  "  To  the 
physician,  whose  province  it  is  to  vanquish  the  disease  that 
brings  its  victim  to  the  very  borders  of  corporeal  dissolution, 
and  to  produce  as  it  were  a  second  creation  of  life — a  greater 
work  than  almost  all  the  other  much-vaunted  performances  of 
mankind — to  him  Nature  in  all  her  wide  expanse,  with  all  her 
sources  and  productions  must  lie  open.  Let  all  hold  aloof 
from  this  most  pious,  this  noblest  of  all  secular  professions, 
who  are  deficient  in  mind,  in  patient  thought,  in  the  requisite 
knowledge,  or  in  tender  philanthropy  and  a  sense  of  duty." 
However  great  may  be  the  general  attainments  of  a  physician, 
there  is  one  kind  of  knowledge  indispensable,  that  of  the  Ma- 


INTRODUCTION. 


teria  Medica :  and  as  none  but  a  charlatan  affects  to  be  able  to 
retain  an  adequate  amount  of  it  in  his  mind,  the  best  phy- 
sicians study  it  at  the  bed-side  of  the  sick,  and  partly  in  a  re- 
pertory, a  Materia  Medica  in  which  the  symptoms  have  an  or- 
derly arrangement,  for  convenience  of  reference  and  greater 
certainty  in  the  selection  of  the  lest  remedy. 

The  Homoeopathic  Materia  Medica  is  the  true  test  of  the 
correctness  of  conclusions  drawn  from  Clinical  experience ; 
indeed,  it  was  originally  the  only  guide  to  that  practice  which 
was  attended  with  such  splendid  results  in  1832.  It  was  Hah- 
nemann's  confidence  in  this,  and  in  his  law  of  cure,  that  en- 
abled him  to  publish  the  plan  on  which  this  fearful  malady  was 
successfully  combated.  With  his  usual  sagacity,  he  pointed 
out  the  true  prophylactics,  and  all  the  most  important  curatives, 
when  this  pestilence  had  not  fallen  under  his  own  observation. 
Having  discovered  and  demonstrated  a  universal,  unerring, 
and  everlasting  law  in  medicine,  he  was  prepared  to  encounter 
the  strangest  forms  of  disease  as  though  they  were  familiar. 
The  law  is  similia  similibus  curantur,  like  are  cured  by  like  ; 
or  (to  expand  this  brief  and  elliptical  aphorism)  diseases  are 
cured  by  medicines  which  tend  to  excite  affections  similar  to 
the  diseases  themselves.  From  the  Greek  opotov  xddos  (ho- 
moion  pathos,  affectus  similis,  the  Latin  term  Homoeopathia, 
and  the  English  Homoeopathy,  are  derived. 

We  frequently  hear  persons  who  have  no  experience  in  Ho- 
moaopathy,  or  who  at  most  have  seen  its  effect  in  Chronic 
cases,  saying,  I  would  not  dare  to  trust  it  if  I  were  very  sick, 
with  a  dangerous  and  rapid  disease.  I  should  want  some- 
thing that  would  act  powerfully  and  quickly.  A  potentized 
medicine  selected  in  accordance  with  the  Homoeopathic  law, 
is  that  very  thing.  Thousands  of  physicians  know  it  to  be 
such  ;  and  that  in  their  own  former  Allceopathic  practice, 
and  in  that  of  their  brethren  of  the  old  school,  no  violent  and 
rapid  diseases  have  been  cured  as  surely  and  promptly  as  they 


10  INTRODUCTION. 

now  cure  them  by  the  homoeopathic  method.  Large  doses 
are  not  required  to  cure  any  disease  whatever.  Attenua- 
tion, whilst  it  weakens  and  ultimately  nullifies  poisons,  as 
such,  is  in  almost  every  substance  essential  to  the  full  de- 
velopment of  medicinal  power  ;  and,  in  some  substances,  no 
medicinal  .power  whatever  is  manifested  until  the  substance  is 
rendered  extremely  dilute.  This  book  will  contain  abundant 
experimental  evidence  of  the  efficacy  of  attenuated  medicines 
in  the  treatment  of  Cholera.  The  great  success  of  European 
physicians  in  the  treatment  of  the  Asiatic  Cholera  of  1832,  and 
of  many  American  physicians  in  1849,  was  due  to  the  use  of 
attenuated  medicines,  as  well  as  to  the  law  of  similitude 
which  regulated  their  administration.  If  the  author  were 
charged  with  the  duty  of  testing  the  relative  merits  of  the  ho- 
moeopathic and  allopathic  laws  of  cure  before  an  impartial 
and  intelligent  tribunal  of  either  school,  and  if  his  life  depended 
upon  obtaining  a  verdict  in  favor  of  Homoeopathy,  he  would 
not  only  select  violent  and  rapid  diseases,  in  preference  to 
such  as  are  mild  and  chronic,  but  would  administer  attenuated 
medicines,  in  small  doses. 

As  the  potencies  and  doses  recommended  by  Dr.  QUIN  of 
London,  and  on  his  authority  in  the  former  editions  of  this 
book,  have  with  all  who  employed  them  in  1849,  well  sustain- 
ed the  reputation  gained  in  1832,  they  have  not  been  changed 
in  the  present  edition.*  In  the  present  state  of  homoeopathic 
science  they  may  be  properly  denominated  the  medium  dilu- 
tions. Those  who  prefer  lower  or  higher  ones,  will  find  no 
difficulty  in  using  this  book  as  a  guide  in  the  selection  and 
administration  of  the  remedies.  The  same  number  of  globules 
and  the  same  intervals  between  the  doses,  will  be  appropriate. 

New-York,  July,  1854. 

*  Other  acknowledgements  of  some  of  the  advantages,  which  this  book  has 
derived  from  the  excellent  French  treatise,  of  this  distinguished  and  venerated 
pioneer  of  sound  Homoeopathy  in  England,  aregiven  on  pages,  71,  121,  123, 
123  and  170 


INTRODUCTION. 


11 


LIST  OF  THE  CHOLERA  MEDICINES, 

WITH    THE    PROPER    ATTENUATIONS. 


Names. 

Aconitum,  24th  attenuation  ; 
Arsenicum,  30th  ;  "*": 

Belladonna,  30th  ;  " 

Camphora,  Tinct.  &  3d,      " 
Cantharis,  30th;  " 

Carbo-v  <retabilis,    30th  ;       " 

•  Chamomilla,  30th  ;  " 
Cicuta,  30th;                         " 
Cinchona,   12th;                   " 
CUPRUM,  30th ;                      " 
Acidum-hydrocianicum,  30th  ; 
Ipecacuanha,  3d,                    " 
Jatropha,  12th  ;                     " 
Mercurius-vivus,  12th;          " 
Natrum-muiiaticum,  12th  ;  lc 
Nux-vomica,  30th  ;               " 

•  PHOSPHORUS,  30th  ;  " 
PHOSPHOEI-ACIDUM,  3d,  &30th 
Rhus-radicans,  30th  ;           " 
Secale-cornutum,  12th  ;       " 
Stramonium,  12th ;              " 

9  Sulphur,   30th  ;  " 

Tartarus-emeticus,  12th  ;  " 
VERATRUM,  12th  &  30th 


Abbreviations. 

Aeon.   2<  * 
Ars.    30 

Bell.    30 

Camph  °  <fe  » 

Caith.    30 

Carb-v.   30 

Cham,  so 

Cic.  30 

Cin.    »» 

CUPR.   ao 

Hydrocy.  Jo 

Ipec.  3 

Jat.  12 

Merc.  12 

Natr-m.  12 

Nux,   so 

PHOS:   3° 

PHOS.-AC.S&  »° 
R.-rad.  30 

Sec.  12 
Stram.    12 
Sulph.  »  o 
Tart.  12 
VERAT. »  2  &  »  o 


*  The  distinctions  of  type  refer  to  the  more  or  less  frequent  demand  for  these 
medicines  in  the  disease  proper.  This  elevated  location  of  the  figures  in  the 
last  column,  promotes  brevity  and  prevents  ambiguity,  where  other  figures  or 
words  follow.  It  is  also  appropriate,  as  the  number  is  the  mathematical  ex- 
ponent of  that  power  of  100  which  expresses  the  degree  of  dilution,  and  of  that 
power  of  1/100,  which  expresses  the  quantity  of  the  medicinal  basis  contained 
in  the  preparation. 


HOMCEOPATHIC  MEDICINES. 

WM.  RA.DDE,  322  Broadway,  New- York,  respectfully  informs  the  Homoeo- 
pathic Physicians  and  the  friends  of  the  System,  that  he  is  the  sole  Agent  for 
the  Leipzig  Central  Homeopathic  Pharmacy,  and  that  he  has  always  on  hand 
a  good  assortment  of  the  best  Homeopathic  Medicines,  in  complete  sets  or  by 
•ingle  vials,  in  Tinctures,  Dilutions,  and  Tritwations ;  also,  Pocket  Gate* 
of  Medicines ;  Physicians'  and  Family  Medicine,  Chests  to  Laurie's  Domestic 
(60  to  82  Remedies).— EPP'S  (60  Remedies).— HERING'S  (60  to  102  Reme- 
dies).— Small  Poctcet-'.ases  at  $3,  with  Family  Guide  and  27  Remedies.— Cotes* 
containing  415  Vials,  with  Tinctures  and  Trilurations  for  Physicians. — Cases 
with  268  vials  of  Tinctures  and  Triturations  to  Jahr's  New  Manual,  or  Symp- 
tomen-Codex. — Physicians'  Pocket  Cases  with  60  Vials  of  Tinctures  and  Tritu- 
rations.— Cases  from  200  to  300  Vials,  with  low  and  high  dilutions  of  medicated 
pellets. —  lases  from  50  to  80  Vials  of  low  and  high  dilutions,  &c.,  <fec.  Ho- 
moeopathic Chocolate.  Refined  Sugar  of  Milk,  pure  Globules,  &c.  Arnica 
Tincture,  the  best  specific  remedy  for  bruises,  sprains,  wounds,  &c.  Arnica 
Plaster,  the  best  application  for  Corns.  Arnica  Salve,  Urtica  urens  tincture 
and  salve  and  Dr.  Reisig's  Homoeopathic  Pain  Extractor  are  the  best  spe- 
cific remedies  for  Bums.  Canchilagua,  a  Specific  in  Fever  and  Ague.  Also 
Books,  Pamphlets  and  Standard  Works  on  the  System  in  the  English,  French, 
Spanish,  and  German  Languages.  9 

f~fp*  Physicians  ordering  medicines  will  please  mark  after  each  one  its  strength 
and  preparation,  as : 

moth,  tinct.  for  mother  tincture. 

1.  trit.  or  3.  trit.  for  first  or  third  trituration. 

6.  in  Uq.  or  30  in  liq.  for  sixth  or  thirtieth  attenuation  in  liquid. 

6.  in  glob,  or  30  in  glob,  for  sixth  or  thirthieth  attenuation  in  globules. 
£^"  Cases  of  27  vials  of  the   cholera   medicines ;  to  accompany  Joslin's 
Cholera,  $3.00. 

Cases  of  12  vials,  containing  the  most  important  cholera  medicines,  to 
accompany  Joslin  on  Cholera,  $1.75. 


CHAPTER    I. 

NATURE    AND    PATHOLOGY 

OF 

CHOLERA, 

WITH  REFERENCE  TO  THE  DARK. COLOR  OF  THE  BLOOD 
AND  THE  DEFICIENCY  OF  ANIMAL  HEAT. 


CHARACTERISTICS. 

THE  disease  which  is  now  generally  known  by  the 
name  of  Cholera,  or  The  Cholera,  and  which  has  been 
denominated  Epidemic,  Asiatic,  Spasmodic  and  Pes- 
tilential Cholera,  and  Cholera  Asphyctica  or  As- 
phyxia, agrees  in  but  few  particulars  with  the  ordi- 
nary Sporadic  or  Bilious  Cholera,  known  by  the  name 
of  Cholera  Morbus.  It  usually  differs  from  the  lat- 
ter in  the  whitish  appearance  of  the  alvine  evacua- 
tions ;  in  the  absence  of  bile  in  them  and  in  the  mat- 
ters vomited ;  and  the  suppression  of  other  secretions, 
especially  that  of  the  urine  ;  in  the  greater  liability 
to  cramps  and  other  spasms  ;  in  the  coldness  of  the 
body,  including  surface,  tongue,  breath,  &c. ;  in  the 
livid  color  of  the  skin  ;  in  the  early  cessation  of  the 
pulse ;  and  in  the  great  rapidity  and  fatality  of  the 
disease. 

2 


14  NATURE    AND    PATHOLOGY 

Dissections  reveal  but  few  and  slight  traces  of  in- 
flammation or  other  morbid  changes  in  the  solid  con- 
stituents of  the  bodies  of  persons  who  have  died  of 
this  disease — none  that  are  constant,  and  in  many 
cases  none  at  all. 

Hence  the  disease  is  calculated  to  confute  the  the- 
ory and  paralyze  the  exertions  of  the  anatomical  sect. 
It  is  found  no  less  puzzling  and  intractable  by  the 
chemical  and  mechanical  sects;  although  they  have 
given  some  attention  to  the  blood,  the  part  in  which 
the  most  important  morbid  alterations  are  found.  The 
chemical  Allopathists  have  endeavored  to  supply 
the  deficiency  of  its  salts  by  artificially  introducing 
them,  either  by  the  mouth  or  the  veins ;  whilst  the 
mechanical  Allopathists,  supposing  that  the  thick- 
ening of  the  blood  was  merely  a  consequence  of  the 
discharge  of  its  watery  parts  into  the  intestines, 
strive  to  arrest  this  discharge  by  opiates  and  astrin- 
gents. The  most  pure  and  perfect  specimen  of  this 
practice,  is  a  plan  proposed  by  an  Allopathic  medi- 
cal professor  :  viz.,  to  cork  up  the  anus. 

The  hints  I  have  to  offer  on  the  pathology  of  this 
disease  may  be  of  some  use,  if  they  serve  no  other 
purpose  but  to  dissuade  from  such  mechanical  views, 
and  teach  that  no  reliance  can  be  placed  on  any  treat- 
ment but  that  which  is  specific  in  its  nature  and 
symptomatic  in  its  rule,  and  which,  under  the  guid- 
ance of  an  unerring  law,  strikes  at  the  secret  springs 
of  morbid  action.  A  consideration  of  the  true  source 


OF    CHOLERA.  15 


of  animal  heat  will  show  the  futility  of  all  attempts 
to  restore  it  by  hot  baths  or  hot  drinks,  whilst  the  vi- 
tal and  chemical  processes  on  which  it  depends  con- 
tinue to  be  interrupted — to  say  nothing  of  the  delu- 
sive analogy  between  actual  warmth  and  that  sensa- 
tion of  warmth  which  is  produced  by  stimulants,  and 
which  has  led  some  to  attach  some  importance  to 
these  in  Cholera. 

Another  object  will  be,  to  point  out  such  relations 
between  certain  pathological  and  aetiological  facts,  as 
will  afford  some  clue  to  the  apparently  anomalous 
character  of  the  predisposing  causes,  to  impress  the 
importance  of  certain  precautionary  measures  relat- 
ing to  diet  and  regimen,  and  afford  aid  in  prognosti- 
cating the  progress  of  the  epidemic. 

One  of  the  most  remarkable  features  of  Cholera 
in  an  advanced  stage,  and  of  the  more  perfect  types 
of  the  disease  almost  immediately  after  its  onset,  is 
the  rapid  failure  of  animal  heat.  The  temperature 
of  the  whole  body  is  greatly  reduced,  and  some  parts 
acquire  a  marbly  coldness  long  before  death.  The 
coldness  of  the  skin,  tongue,  breath,  &c.,  I  have  fre- 
quently observed,  and  others  have  a  thousand  times 
described.  These  phenomena  must  be  attributed  to 
some  impression  which  the  poison — probably  intro- 
duced through  the  lungs  into  the  blood — has  made 
upon  the  nervous  system  ;  an  impression  which  inter- 
feres with  the  introduction  of  oxygen  into  the  blood, 
or  with  its  chemical  action  on  the  carbon  and  hydro- 
gen. 


16  NATURE   AND    PATHOLOGY 

PHYSIOLOGY      OF      RESPIRATION. 

With  respect  to  animal  heat  in  ^<ni  nil.  the  results 
of  Mr.  Brodie's  experiments  were,  for  a  while,  thought 
by  many  to  be  fatal  to  every  modification  of  the 
chemical  theory,  from  those  of  Black  and  Lavoisier  to 
that  of  Crawford.  But  the  later  and  more  careful 
experiments  and  more  correct  reasonings  of  Drs. 
Philip,  Legallois,  Edwards,  and  Liebig,  have  tended 
to  restore  the  chemical  theory,  so  far  at  least  as  it  re- 
spects the  general  doctrine  of  the  dependence  of  calo- 
rification on  the  absorption  of  oxygen  and  the  pro- 
duction of  carbonic  acid.  But  although  respiration 
must  be  considered  essential  to  animal  heat,  some 
physiologists  are  still  disposed  to  attribute  calorifica- 
tion, in  part,  to  the  direct  actions  of  the  nervous  and 
circulatory  systems.  The  influence  of  these,  howe- 
ver, appears  to  be  indirect.  The  contact  and  combina- 
tion of  the  oxygen  with  the  blood,  is  promoted  by  in- 
nervation  and  circulation,  whilst  the  latter  diffuses 
through  the  system  that  caloric,  which  by  the  union 
of  oxygen  with  carbon  and  hydrogen,  is  evolved  on 
the  same  principle  as  in  combustion. 

Without  dwelling  upon  the  analogy  between  respi- 
ration and  combustion,  or  upon  the  influence  of  hy- 
drogen, it  will  be  sufficient  barely  to  allude  to  a  few 
of  the  numerous  experiments  and  observations,  which 
prove  a  necessary  relation  between  the  amount  of 
carbonic  acid  produced  during  respiration  and  that 
of  caloric  evolved  in  the  system.  For  example,  Le- 


OF    CHOLERA.  IT 

gallois  effected  a  diminution  in  both,  by  placing  an 
animal  in  such  a  position  as  constrained  its  respira- 
tion. Edwards  ascertained  that  both  were  affected 
in  a  corresponding  manner  by  the  influence  of  the 
seasons  :  for  in  summer,  less  carbonic  acid  was  formed, 
and  likewise  less  heat  was  evolved.  The  latter  fact 
was  not  a  mere  inference  from  the  former,  but  was 
established  by  exposing  the  same  kind  of  animal  to 
the  same  freezing  mixture  in  winter  and  in  summer, 
and  finding  that  in  the  latter  season,  the  reduction  of 
its  temperature  was,  in  a  given  time,  six  or  eight 
.  times  as  great  as  in  winter. 

The  final  cause  of  this  correspondence  between  the 
oxygen  consumed  and  the  temperature  of  the  sur- 
rounding medium,  is  as  obvious  as  it  is  interesting. 
This  is  a  beneficent  provision,  by  which,  as  well  as  by 
a  variable  cutaneous  and  pulmonary  transpiration, 
the  Author  of  nature  has,  in  some  degree,  defended 
man  and  the  inferior  animals  against  the  vicissitudes 
of  the  seasons.  But  neither  our  limits  nor  the  nature 
of  our  subject  will  allow  us  to  dwell  upon  this  inter- 
esting topic. 

That  correspondence  between  the  degrees  of  ae'ra- 
ttion  and  those  of  animal  heat,  which  has  been  already 
alluded  to,  extends  to  the  whole  animal  kingdom. 
It  will  be  found  to  exist,  whether  we  compare  the 
warm-blooded  animals  with  those  called  cold-blooded, 
or  the  different  species  of  either  of  these  grand  divi- 
sions with  each  other.  The  respiration  of  the  lower 
orders  of  animals  is,  however,  so  imperfect,  and  their 


18  NATURE    AND    PATHOLOGY 

temperature  is,  consequently,  so  little  elevated  above 
that  of  the  media  in  which  they  reside,  that  the  evi- 
dence of  the  extension  of  the  above  law  to  them  was 
at  one  time  merely  analogical.  But  discoveries  in 
electro-magnetism  have  suggested  an  extremely  deli- 
cate thermometer,  by  means  of  which,  the  relation' 
that  in  the  higher  classes  of  animals,  is  known  to  ex- 
ist between  animal  heat  and  aeration,  is  proved  to 
hold  even  among  different  species  of  insects  as  com- 
pared with  each  other;  those  which  produce  more 
carbonic  acid,  possess  a  more  elevated  temperature. 
This  may  therefore  be  regarded  as  a  universal  law. 

There  is  no  difficulty  in  understanding  why  the 
skin  should  have  a  dark  color,  whenever  the  deficien- 
cy of  animal  heat  in  the  body,  and  of  the  oxygen  used 
and  the  carbonic  acid  formed  during  respiration,  evince 
an  accumulation  of  carbon  in  the  blood. 


APPLICATION      TO     THE     PATHOLOGY     OF 
C  H  OLEK A . 

That  a  dark  color  of  the  blood  is  one  of  the  char- 
acteristics of  Cholera,  is  well  known.  To  this  color^ 
of  the  blood  we  are  to  attribute  the  livid  color  of  the 
surface  of  the  body — a  color  which  is-  not,  however, 
identical  with  that  of  the  blood,  but  depends  partly 
upon  the  color  of  the  medium  through  which  the  blood 
is  seen. 

In  this  disease,  there  is  frequently  no  sensible  dif- 


OF    CHOLERA.  19 


ference  between  the  color  of  the  venous  and  that  of 
the  arterial  blood.  Many  physicians  have  compared 
the  blood  to  tar  or  treacle.  The  blood  drawn  from  a 
patient  was  found  by  Dr.  Reid  Clanny  to  be  as  black 
as  tar,  and  to  contain  more  than  twice  as  much  carbon 
as  healthy  blood.  It  was  tasteless,  and  contained  no 
carbonic  acid  or  gas  of  any  kind.  The  want  of  taste 
cannot  be  wholly  referred  to  the  elimination  of  salts, 
but  affords  evidence  of  a  defect  in  the  respiratory  func- 
tion ;  for  the  stronger  taste  is  one  of  the  properties 
acquired  by  this  liquid  in  traversing  the  lungs ;  and  as 
superior  sapidity  distinguishes  arterial  from  venous 
blood,  we  might  naturally  expect  it  to  distinguish  ve- 
nous blood  from  supervenous. 

Whether  the  carbon  which  he  obtained  by  his  ulti- 
mate analysis,  previously  existed  in  a  free  state,  as 
he,  in  my  opinion,  too  hastily  concluded,  is  of  little 
consequence.  None  of  those  who  have  objected  to 
his  views,  have  produced  any  ultimate  analysis  which 
Militates  against  his  conclusion,  that  there  is  a  great 
excess  of  carbon,  compared  with  that  which  exists  in 
normal  blood.  In  the  controversy  which  has  been 
carried  on  by  Dr.  Clanny  and  others,  the  object  has 
been,  either  to  prove  or  disprove  the  existence  of  car- 
bon in  the  blood  in  a  free  state,  and  the  excess  of  un- 
combincd  carbon  in  cholera  blood.  The  decision  of 
this  point  is  probably  of  little  importance  in  the  pa- 
thology of  Cholera  ;  at  any  rate,  it  does  not,  in  the 
least,  affect  the  question  which  I  am  considering. 
The  manner  in  which  the  elements  of  that  part  of 


.\.\Ti  BE    AM>    PAl  HO] 


the  coloring  matter  which  contains  carbon,  are  ar- 
ranged, whether  in  binary,  ternary  or  quaternary 
combination,  has  never  been  determined  ;  but  Brande, 
Engelhart  and  Michaelis  have  shown  that  the  color- 
ing matter  of  the  blood  consists  of  an  animal  matter, 
associated  with  a  minute  quantity  of  iron  and  some 
earthy  salts  ;  and  this"  animal  matter,  of  which  the 
coloring  matter  appears  chiefly  to  consist,  was  found 
by  Michaelis  to  contain  more  than  fifty-three  per 
cent,  of  carbon.  Now  in  what  degree  the  carbon  of 
the  coloring  matter  may  vary  in  different  kinds  of 
blood,  I  find  no  satisfactory  data  for  determining. 
The  furnishing  of  these  is,  perhaps,  a  service  which 
pathology  has  yet  to  expect  from  chemistry.  But  even 
conceding,  that  a  given  quantity  of  the  coloring  mat- 
ter of  cholera  blood,  contains  only  the  same  amount  of 
carbon  as  the  same  quantity  of  the  coloring  matter  of 
normal  blood,  (and  no  one  has  pretended  that  it  con- 
tains less,)  it  can,  I  think,  be  shown,  that  the  whole 
amount  of  carbon  in  the  coloring  matter  of  the  for- 
mer, far  cxeceds  the  whole  amount  in  the  coloring 
matter  of  the  latter.  For  according  to  the  research- 
es of  Dr.  Thompson,  professor  of  Chemistry  in  Glas- 
gow, the  coloring  matter  of  cholera  blood,  as  deduced 
from  the  mean  of  his  results,  is  "little  short  of  four 
times  the  quantity  of  coloring  matter  of  healthy 
blood."  Dr.  Clanny's  proximate  analysis  afforded 
nearly  the  same  result.  This  maybe  reconciled  witli 
the  result  of  his  destructive  distillation  in  another 
instance,  in  which  he  obtained  only  about  twice  as 


OF   CHOLERA.  21 


much  carbon  from  cholera  blood  as  from  healthy 
blood,  by  considering  that  both  fibrine  and  albumen 
contain  rather  more  than  fifty  per  cent,  of  carbon, 
and  that  the  great  increase  of  coloring  matter,  is 
partly  compensated  by  the  diminution  of  the  sum  of 
these  other  carbonaceous  principles.  That  this  will 
explain  the  apparent  discrepancy,  might  be  shown  by 
the  numerical  results.  But  that  the  change  in  the 
absolute  amount  of  fibrine  is  small,  compared  with 
that  of  the  coloring  matter,  is  evident  from  Dr. 
Thompson's  testimony,  that  the  fibrine  and  coloring 
matter  of  healthy  blood  added  together,  amount  to 
less  than  one-half  the  coloring  matter  in  cholera 
blood.  Notwithstanding  all  that  has  been  said  by 
the  opponents  of  hyperanthraxis,  I  am  unable  to  dis- 
cern, why  the  quantities  of  carbon  obtained  from  two 
portions  of  blood,  submitted  under  the  same  circum- 
stances, to  destructive  distillation  in  a  close  vessel, 
may  not  correctly  show  the  relative  proportions  that 
actually  existed  in  them.  The  only  sound  objection 
refers  to  the  state  in  which  the  carbon  existed. 

Now,  that  this  vast  accumulation  of  carbon  in  the 
blood  of  a  cholera  patient  is  absolute,  and  not  merely 
a  relative  increase,  resulting  from  incrassation,  in 
consequence  of  the  removal  of  its  aqueous  portion, 
by  profuse  evacuations  or  any  other  cause,  we  may 
readily  convince  ourselves  from  a  comparison  of  the 
numerical  results  in  Dr.  Thompson's  table,  by  which 
it  will  be  found,  that  the  proportional  diminution  of 
water  in  cholera  blood  is  very  small,  compared  either 


22  NATURE    AND    PATHOLOGY 

with  the  proportional  increase  of  coloring  matter  as 
shown  by  his  experiments,  or  of  carbon  as  shown  by 
Dr.  Clanny's.  How  then  can  it  be  true,  that  the  ad- 
dition of  the  dejections  to  the  blood  would  restore  it 
to  its  normal  condition  ?  Are  not  even  Dr.  O'Shaug- 
nessy's  results  with  respect  to  the  albumen,  opposed 
to  the  above  conclusion  which  has  been  drawn  from 
his  analysis  ?  The  history  of  this  epidemic  is  oppos- 
ed to  it.  It  has  been  long  since  and  repeatedly  ob- 
served, by  those  who  have  been  familiar  with  the  dis- 
ease in  its  most  malignant  and  perfect  form,  that  the 
most  rapid  and  intractable  cases  were  generally  at- 
tended with  slight,  if  any,  alvine  evacuations.  Not 
to  cite  other  authorities,  Mr.  Orton,  at  Bombay,  and 
other  surgeons  in  that  vicinity,  stated  that  in  many 
cases  there  was  no  purging,  in  some  no  vomiting,  and 
in  others  neither,  and  that  these  were  by  far  the  most 
dangerous  cases,  and  that  the  patients  died  under 
them,  often  in  an  hour  or  two ;  and  that,  without 
spasms  and  with  scarcely  any  vomiting  or  purging, 
all  the  secretions  appeared  to  be  in  many  cases  en- 
tirely suspended.*  Conceding  the  possibility,  that 
in  some  cases,  the  contents  of  the  alimentary  canal 
may  not  have  been  examined,  still,  from  what  we 
know  of  its  dimensions,  and  from  the  effects  of  equiva- 
lent evacuations  in  other  diseases,  a  theory  which 
can  be  defended  only  by  a  supposed  accumulation  in 
such  cases,  must  be  considered  untenable.  Has  it 

*Good's  Study  of  Med.  I.  178. 


OP  CHOLERA.'.  23 


not  been  chiefly  in  those  places  which  have  been  but 
slightly  visited,  that  we  find  pathologists  disposed  to 
found  a  theory  on  profuse  evacuations  1  Under  such 
circumstances,  these  may  perhaps  merit  all  the  atten- 
tion which  has  been  bestowed  upon  them  ;  although 
the  most  fatal  alterations  of  the  blood,  and  the  sup- 
pression of  urine  and  other  secretions,  must  often,  if 
not  always,  depend  upon  another  cause.* 

It  is  hardly  necessary  to  remark,  that  the  presence 
of  an  immense  excess  of  carbon  in  the  blood,  mani- 
fests a  defect  in  the  decarbonizing  process  of  the  sys- 
tem. It  may  be  less  obvious,  though  hardly  less  cer- 
tain, that  the  observed  absence  of  carbonic  acid  in 
the  blood,  in  this  disease,  depends  upon  a  similar 
cause.  A  considerable  quantity  of  this  gas  exists  in 
healthy  blood ;  and  it  might  be  asked,  why  the  same 
cause,  from  which,  in  this  disease,  the  blood  retains 
its  carbon,  does  not  also  make  it  retain  the  carbonic 
acid.  I  answer,  it  is  because  the  carbonic  acid  elimi- 

*  There  is  little  doubt  that  the  secretion  of  urine  may  be  both  in- 
creased and  diminished,  by  some  agencies  which  have  no  direct  in- 
fluence on  the  action  of  the  kidneys,  or  the  quantity  of  serum  in 
the  blood.  Even  Dr.  Cullen  acknowledged  his  suspicion  of  this, 
opposed  as  it  was  to  his  favorite  theory.  His  modesty  and  candor 
are  worthy  of  the  imitation  of  those  who  are  ambitious  of  framing 
complete  theories  in  medicine.  He  says,  that  "besides  the  increased 
quantity  of  water  in  the  mass  of  the  blood,  or  a  stimulus  particularly 
applied  to  the  kidneys,  there  may  be  a  medicine  which,  by  a  general 
operation  on  the  system,  may  promote  the  secretion  of  urine. — My 
candor  obliges  me  to  mention  this ;  but  I  do  not  find  myself  at  pc* 
sent  in  a  condition  to  prosecute  the  inquiry. — Materia  Med.  vol. 
p.  556. 


24  NATURE    AND   PATHOLOGY 

nated  during  respiration,  derives  its  oxygen  from  the 
inspired  air ;  and  when  little  or  no  oxygen  is  absorb- 
ed, we  should  expect  little  or  no  carbonic  acid  to  be 
formed.  From  the  absence  or  deficiency  of  carbonic 
acid,  I  should  infer,  that  in  this  disease,  there  exists 
more  difficulty  in  obtaining  the  advantages  of  in- 
spiration than  those  of  expiration — in  forming  car- 
bonic acid  than  in  eliminating  it. 

In  the  phenomena  presented  after  death,  there  are 
many  striking  coincidences  between  Cholera  and  as- 
phyxia from  other  causes ;  the  same  fluidity  of  the 
blood,  for  hours  after  death,  the  same  tendency  of  the 
body  after  death  to  an  increase  of  warmth  and  dimi- 
nution of  lividity,  as  in  cases  where  the  respiration 
is  suspended  by  hanging  or  drowning,  or  not  estab- 
lished by  a  closure  of  the  foramen  ovale.  I  have 
known  these  phenomena  to  be  presented  after  death 
in  the  case  of  a  premature  child,  which  was  born  at 
the  end  of  the  7th  month,  and  lived  till  the  fourth 
day  after  its  birth ;  and  I  have  observed  some  of 
them  in  cases  of  death  by  hanging  and  drowning,  and 
I  believe  them  to  be  characteristic  of  asphyxia. 
They  frequently  inspire  the  friends  of  the  deceased 
with  the  vain  hope  of  effecting  a  resuscitation. 

The  following  case  will  illustrate  some  of  the  fore- 
going remarks,  as  well  as  the  effect  produced  on  the 
blood  by  certain  salts,  which,  since  the  experiments 
of  Dr.  Stevens,  have  been  supposed  to  perform  an 
important  part  in  the  function  of  respiration.  A  son 
of  Mr.  V.  V.,  aetat.  eighteen  months,  had  fallen  into 


OP    CHOLERA.  25 


a  cistern  of  water,  and  lain,  as  was  supposed,  a  quar- 
ter of  an  hour  or  more,  and  had  been  taken  out  ahout 
half  an  hour  before  my  arrival.  We  attempted  to 
re-establish  respiration,  by  inflating  the  lungs,  not 
only  by  the  mouth,  but  by  a  pair  of  bellows  fitted  to 
a  flexible  tube  which  was  introduced  into  the  trachea. 
Other  means  were  used,  but  to  no  effect.  About  twp 
hours  after  the  death  of  the  child,  the  jugular  vein 
was  opened.  A  dark-colored  blood  ran  freely.  Three 
or  four  ounces  were  taken.  Its  coagulability  was  so 
slight,  that  it  required  a  plaster  to  arrest  it.  As  the 
plasticity  or  coagulability  of  arterial  blood  as  com- 
pared with  venous,  is  a  property  acquired  by  respira- 
tion, it  might  be  expected,  that  the  supervenous 
blood-  of  Cholera  and  other  species  of  asphyxia, 
would  be  more  deficient  in  this  property  than  ordina- 
ry venous  blood.  And  such  is  the  fact.  In  the 
above  case,  it  coagulated  very  slowly  and  imperfectly 
after  its  removal  from  the  vein,  resembling,  in  this 
respect,  the  blood  drawn  during  life  from  Cholera 
patients.  After  half  an  hour  had  elapsed,  about  one- 
third  of  it  had  not  coagulated,  although  the  tempera- 
ture of  the  air  was  about  70°.  The  upper  part, 
which  had  been  exposed  to  the  air,  was  coagulated  to 
a  certain  depth,  and  its  color  at  the  surface  had  be- 
come rather  brighter.  On  inclining  the  vessel,  the 
dark,  thick  and  uncoagulated  fluid  broke  through  the 
coagulated  crust,  and  flowed  sluggishly  across  it, 
presenting  an  appearance  somewhat  similar  to  that 
of  Cholera  blood,  which  from  its  consistence  and 


NATURE   AND   PATHOLOGY 


blackness,  has  so  often  been  compared  to  molasses 
and  tar.  The  parts  of  the  coagulum  below  the  sur- 
face were  also  dark-colored.  It  appeared  evident, 
that  air  favored  coagulation,  and  was  more  essential 
to  the  production  of  the  florid  color,  but  did  not  ap- 
pear to  effect  the  latter  as  readily  and  perfectly  as  in 
the  case  of  normal  or  healthy  blood.  Muriate  of  so- 
da was  then  added  to  one  portion,  and  carbonate  of 
soda  to  another.  The  latter  had  a  marked  effect, 
rendering  it  florid.  This  experiment,  and  others 
made  on  normal  venous  blood,  have  convinced  me  that 
it  is  unphilosophical  to  infer  from  the  effect  of  salts 
in  reddening  cholera  blood,  that  the  asphyxia  which 
produces  its  dark  color  depends  on  the  deficiency  of 
saline  ingredients  in  the  blood,  even  though  such  de- 
ficiency should  by  analysis  be  shown  to  exist ;  for  in 
the  case  above  mentioned,  and  in  others  alluded  to,  a 
similar  change  of  color  was  produced  by  the  salts,  al- 
though there  was  no  reason  to  suspect  any  greater 
deficiency  of  saline  ingredients  than  ordinarily  exists 
in  venous  blood.  The  circumstance  that  the  color  of 
the  blood  was  less  influenced  by  exposure  to  air  than 
ordinary  venous  blood,  shows  that  a  defect  in  this 
property  is  not  peculiar  to  Cholera,  nor  to  disease  of 
any  kind,  properly  so  called,  but  appears  to  be  char- 
acteristic of  asphyxia  in  general,  whether  induced  by 
disease  or  suddenly  caused  by  interrupting  the  respi- 
ration of  an  individual  previously  in  health,  when 
there  have  been  no  intestinal  discharges  to  drain  the 
salts  from  the  system. 


OF    CHOLERA.  27 


I  consider  the  defect  in  coagulability  as  also  com- 
mon to  all  those  cases  where  a  want  of  due  oxygena- 
tion  is  the  sole  or  chief  cause  of,  death.  Excessive 
exercise  and  violent  mental  emotions,  when  they  oc- 
cur suddenly,  are  said  to  produce  this  state  of  the 
blood  ;  and  it  appears  to  me  an  interesting  fact,  that 
these  are  also  among  the  causes  which  tend  to  pre- 
vent its  oxygenation.  Another  correspondence  not 
less  curious  is,  that  in  the  foetus,  whose  respiration 
has  never  been  established,  the  venous  and  arterial 
blood,  like  that  of  the  victims  of  Cholera,  is  nearly 
identical ;  the  blood  is  not  coagulable,  has  an  unctu- 
ous feel,  and  does  not  take  the  vermilion  color  on  ex- 
posure to  the  air  ;  and  according  to  Fourcroy,  it  has 
its  coloring  matter  darker  and  more  abundant,  and 
contains  no  fibrine.  It  therefore  remarkably  resem- 
bles Cholera  blood.  Would  it  not  seem,  from  these 
facts  and  considerations,  that  the  coagulation  of  the 
fibrine,  and  even  its  existence  as  such,  are  more  de- 
pendent on  respiration  than  has  been  hitherto  sus- 
pected ;  and  that  the  deficiency  of  this  principle,  as 
well  as  the  existence  of  most  of  the  other  peculiari- 
ties Avhich  distinguish  cholera  blood  from  normal 
blood,  result  chiefly  from  its  defective  aeration,  and 
are  what  might  be  expected  in  asphyxia  from  any 
other  cause  ?  Dr.  Good  admits  the  want  of  coagula- 
bility of  the  blood  in  cases  of  electrical,  and  Brous- 
sais  in  cases  of  gaseous  asphyxia.  Combining  these 
two  authorities,  relating  respectively  to  asphyxia 
caused  by  lightning  and  that  caused  by  the  irrespira- 


28  NATURE    AND    PATHOLOGY 

blc  and  deleterious  gases,  with  my  own  observations 
on  other  varieties  of  asphyxia,  I  am  led  to  infer  the 
generality  of  the  above  law.  That  the  tarry  appear- 
ance of  cholera  blood  results  from  want  of  aeration, 
is  also  confirmed  by  the  fact,  that  the  same  appear- 
ance may  be  immediately  produced  by  prussic  acid, 
but  never  unless  given  in  such  doses  as  to  occasion 
difficulty  of  breathing.* 

A  defect  in  calorification  and  sanguification  may 
exist,  in  a  slight  degree,  in  an  early  stage  of  the  dis- 
ease, and  not  become  the  most  obvious  characteristic 
till  the  last.  Before  any  profuse  alvine  evacuations 
had  taken  place,  I  have,  in  several  instances,  observed 
a  coldness  of  the  hands  and  feet,  a  blueness  of  the 
under  eyelid,  and  a  preternaturally  dark  color  of  the 
blood  drawn  from  the  arm.  In  this  stage  also,  Dr. 


*  Am.  Jour,  of  Med.  ScL  vol.  xi.  p.  501,  from  a  European  Jour- 
nal.— Dr.  Hartwig,  who  made  this  discovery,  blackened  the  blood  by 
dim-rent  acids,  but  could  not,  it  appears,  produce  this  effect  by  nitric 
acid. — Ibid.  I  have,  however,  ascertained  by  experiment,  that  nitric 
aeid  dues  render  the  sanguineous  coloring  matter  black  as  seen  by 
riJJi-rtr.il  (though  not  as  seen  by  transmitted)  light.  Has  this  dis- 
tinction between  the  reflected  and  transmitted  light  been  made  by 
those  Who  "have  experimented  on  the  blood!  By  other  experiments 
on  blood  more  nearly  normal,  I  have  proved,  that  the  effect  of  saline 
substances  on  the  blood  at  one  temperature,  cannot  be  inferred  from 
experiments  made  at  another;  and  that  the  blackening  of  crass a- 
mcntum  by  hot  water,  is  not,  as  has  been  asserted,  dependent  on 
the  extraction  of  its  saline  matters  ;  and  also,  that  the  ch;i" 
color  produced  in  the  sanguineous  coloring  matter  by  he.-it.  is  not  the 
result  of  the  extrication  of  oxygen  or  any  other  gas.  For  tin 
periments,  vide  Transactions  of  the  Medical  Society  of  the  State  of 
New- York,  vol.  ii.  p.  181. 


OF    CHOLERA.  29 


Baircl  found  the  heat  of  the  skin  below  the  healthy 
standard.  Dr.  Mclntyre  notices  a  slightly  discolored 
state  of  the  under  eyelid,  as  among  the  most  frequent 
premonitory  symptoms.  Others  have  observed,  that 
the  dark  color  of  the  skin  frequently  prevails  as  a 
premonitory  symptom  from  one  to  ten  days,  whilst 
there  is  no  peculiarity  in  the  evacuations. 

That  no  other  disease  effects  so  remarkable  a 
change  in  the  composition,  color  and  temperature  of 
the  blood,  must  be  admitted ;  also  that  these  altera- 
tions are  disproportionate  to  the  amount  of  alvine 
evacuations,  whether  we  compare  different  cases  of 
this  disease,  or  this  disease  with  others ;  although, 
neither  the  physiology  of  respiration,  the  chemistry 
of  normal  blood,  nor  the  chemical  pathology  of  Chole- 
ra, is  so  complete,  as  to  justify  any  positive  opinion 
as  to  the  precise  time,  nor  any  complete  theory  of 
the  manner,  in  which  these  changes  commence.  In- 
deed, the  pathogeny  of  most  diseases  is  obscure  ;  and 
pathology  seldom  detects  the  first  links  in  the  chain 
of  morbid  phenomena.  In  Cholera,  it  can  hardly  be 
considered  more  fortunate  with  respect  to  some  of 
the  subsequent  ones.  There  is  no  complete  theory  ; 
and  I  do  not  offer  the  above  as  such. 

Fortunately  for  mankind,  Hahnemann  has  discov- 
ered a  law  of  cure  which  is  not  based  upon  pathologi- 
cal speculations.  The  want  of  such  a  law  and  of  any 
reliable  guide,  is  the  real  cause  of  the  want  of  una- 
nimity and  I  may  say  the  uncertainty,  confusion  and 
anarchy,  that  prevails  in  the  allopathic  school. 


30  CAUSES 

These  have,  in  the  case  of  no  disease,  been  more 
conspicuous  than  in  relation  to  Cholera,  and  never 
more  so  than  at  the  present  time. 


CHAPTER  II. 

M  T  I  0  L  0  GY, 

ESPECIALLY   WITH   REFERENCE   TO  THE   PREDIS- 
POSING AND   OCCASIONAL   CAUSES. 


PRELIMINARY    2ETIOLOGICAL    REMARKS. 

The  peculiar  cause  of  the  Cholera  is  unknown. 
Hahnemann,  and  some  other  learned  men,  have 
thought  it  to  be  probably  an  animated  miasm.  It 
seems  frequently  to  manifest  some  self-moving  power, 
or  at  least  to  be  capable  of  diffusing  itself  and  of 
travelling,  independently  of  transportation  by  hu- 
man beings,  or  by  the  wind.  Whatever  be  its  na- 
ture, whether  animalcular,  gaseous,  or  electrical,  it 
must  possess  extreme  tenuity  to  escape  detection ; 
and  its  terrific  potency  is  well  calculated  to  rebuke 
the  scepticism  of  those  who  sneer  at  the  evidence  of 
efficiency  in  attenuated  medicines,  and  in  everything 
not-cognizable  by  their  senses  of  sight,  smell,  hear- 
ing, taste  or  touch. 

But  as  the  nature  of  the  cause  of  Cholera  is  in- 
volved in  obscurity,  and  as  I  shall  under  the  head  of 


OF    CHOLERA.  81 


infection,  give  some  views  in  relation  to  its  propaga- 
tion, I  shall  here  limit  myself  to  its  predisposing 
and  occasional  causes,  as  related  to  the  pathological 
phenomena  ahove  considered. 

If  we  say  that  Cholera  is  attended  with  great  de- 
pression of  the  vital  forces,  and  that  the  predisposing 
causes  are  such  as  depress  these  forces  or  produce 
general  debility,  we  make  a  statement  which  is,  to  a 
certain  extent  and  in  a  certain  sense,  correct,  but  is 
deficient  in  definite  meaning,  and  but  partially  true 
in  any  sense.  If  it  were  strictly  and  generally  true, 
we  should  expect  that  individuals  who  were  robust 
and  muscular,  and  at  the  middle  period  of  life,  would, 
cseteris  paribus,  have  a  comparative  immunity  from 
the  disease.  But  this  is  far  from  being  the  fact. 
The  views  about  to  be  presented,  not  only  refer  to  a 
definite  function,  but  to  a  class  of  correspondences 
which  are  more  marked  in  Cholera  than  in  any  other 
disease. 

There  are  many  reasons  for  believing,  that  during 
the  prevalence  of  Cholera  there  is  some  wide-spread 
miasm  or  other  aerial  epidemic  influence  tending  to 
diminish  the  aeration  of  the  blood.  We  have  per- 
haps some  indirect  evidence,  in  the  nearly  simultane- 
ous prevalence  of  certain  diseases  in  which  the  blood 
is  similarly  affected,  though  in  an  inferior  degree. 
Is  there  not  in  many  places,  either  antecedently,  or 
subsequently,  an  increased  prevalence  of  certain  dis- 
eases Avhich  are  attended  with  dark  blood,  such  as 
measles,  and  typhus  and  other  malignant  and  occa- 


32  CAUSKS 

sionally  anomalous  fevers?  For  weeks  and  months 
before  the  acknowledged  incursion  of  Cholera,  there 
are  frequently  cases  of  disease  which  in  these  re- 
spects nearly  resemble  it,  as  I  am  convinced  by  my 
own  observations  and  those  of  many  other  physi- 
cians. 

But  to  give  more  satisfactory  proof  of  this  con- 
nexion between  Cholera  and  respiration,  I  shall  pro- 
ceed to  examine,  whether  the  history  of  Cholera  does 
not  present  a  class  of  etiological  facts,  which,  con- 
sidered in  connexion  with  the  resulfs  of  experiments 
that  have  been  made  on  respiration,  without  any  re- 
ference to  Cholera,  tend  to  confirm  the  foregoing 
views  with  regard  to  one  of  its  principal,  if  not  es- 
sential features. 


ATMOSPHERIC      HEAT. 

The  influence  of  external  heat  on  respiration  was 
discovered  by  Crawford.  His  experiments  and  those 
of  others  have  satisfactorily  shown,  that  the  quantity 
of  oxygen  consumed  and  of  carbonic  acid  produced 
during  respiration,  is  less  as  the  temperature  of  the 
air  is  more  elevated.  All  who  have  experimented  on 
the  subject,  with  but  one  exception,  have  detected 
this  influence  of  temperature.  Crawford  found  that 
a  Guinea  pig,  confined  in  air  at  the  temperature  of 
55°  Fah.,  consumed  double  the  quantity  of  oxygen 
which  it  did  in  air  at  104°.  In  the  case  of  human 
respiration,  Lavoisier  and  Seguin  ascertained,  that 


OF    CHOLERA. 


33 


the  quantity  at  57°  is  to  that  at  82°  as  1344  is  to 
1210.  Delaroche,  in  his  last  series  of  experiments, 
made  the  average  ratio  about  as  six  to  five  at  the 
temperatures  tried  by  him.  He  found,  that  by  ele- 
vation of  temperature,  the  production  of  carbonic 
acid  was  diminished,  and  the  absorption  of  oxygen 
diminished  in  a  still  higher  ratio.  More  recently  Dr. 
Edwards  has  examined  the  effect  of  different  seasons, 
and  found  that  the  long-continued  actions  of  heat 
and  cold  affect  the  respiration  as  a  vital  function; 
the  oxygen  consumed  being  less  in  summer,  even 
when  the  air  in  which  the  animal  is  confined  at  the 
time,  is  of  the  same  density  and  temperature.  More- 
over, from  the  experiments  above  related  respecting 
the  influence  of  sudden  changes  of  temperature,  as 
well  as  from  the  known  effect  of  temperature  on  den- 
sity, it  appears  to  me  evident,  that  its  physical  chan- 
ges between  winter  and  summer,  must  be  such  as  to 
make  the  immediate  influence  of  heat  conspire  with 
its  gradual  physiological  effects,  and  render  the  con- 
sumption in  winter  and  summer  still  more  dispropor- 
tionate. The  influence  of  heat  in  diminishing  the 
consumption  of  oxygen  may  be  considered  as  estab- 
lished. 

On  the  other  hand,  few  facts  are  better  established, 
than  the  influence  of  hot  climates  and  the  warm  sea- 
son of  the  year  in  predisposing  to  Cholera.  The  epi- 
demic in  1817 — which  subsequently  spread  over  a 
considerable  portion  of  the  globe,  and  arrived  here  in 
1832 — commenced  in  summer  in  the  hot  climate  of 


34  CAUSES 

Hindostan;  it  has  generally,  in  all  climates,  been 
much  checked  if  not  extinguished  by  winter ;  also  on 
cold,  elevated  mountains.  Its  ravages  in  Mexico 
proved,  that  it  can  rise  to  a  great  height  above  the 
surface  of  the  sea  in  warm  climates.  In  Russia,  the 
southern  regions  were  those  where  it  spread  most 
widely  and  rapidly;  and  those  towns  which  it  entered 
at  the  end  of  autumn,  suffered  but  slightly.*  It  is 
no  evidence  against  these  views,  that  it  lingered  in 
winter,  in  some  of  the  highly-heated,  ill-ventilated 
and  filthy  rooms  of  that  country.  Even  in  Persia 
and  Asia  Minor,  the  influence  of  winter  on  epidemic 
cholera  was  manifest  during  several  successive  years.t 
This  influence  of  temperature  has  been  confirmed  by 
the  progress  of  the  disease  on  the  western  continent. 
In  1832,  it  commenced  in  spring,  and  until  the  autum- 
nal cold,  nothing  impeded  its  rapid  march  or  changed 
its  malignant  character.  Both  were  restored  by  the 
heat  of  the  ensuing  spring;  and  again  suspended  by 
winter.  In  its  second  tour  in  1849,  the  influence  of 
temperature  was  manifest.  At  the  Quarantine  on 
Staten  Island,  it  disappeared  at  the  commence- 
ment of  the  first  severe  cold  of  January ;  and  even 
the  cold  of  December  was  sufficient  to  arrest  it  in 
the  city  of  New- York,  which  had  been  slightly  in- 
oculated. We  owe  our  present  immunity,  our  respite, 
to  cold.  The  epidemic  in  New-Orleans  in  1848,  pre- 
vailed in  its  greatest  intensity  when  the  thermometer 

*  Report  of  M.  Moreau  <le  Jonnes. 
t  Report  of  the  French  Academy. 


OF    CHOLERA. 


35 


stood  at  its   greatest  height,  and  disappeared  when 
the  weather  became  sufficiently  cold. 


BECOMING  CHILLED  BY  COLD  AIR  OR 
BY  COLD   BATHING. 

It  is  remarkable,  that  the  transient  application  of 
a  cold  sufficient  to  produce  a  certain  degree  of  chilli- 
ness, produces  the  same  effect  as  long-continued  heat, 
both  in  relation  to  Cholera  and  to  respiration. 

It  is  known  that  becoming  chilled  greatly  increa- 
ses the  liability  to  Cholera. 

Dr.  Edwards  found  that  in  the  animals  on  which 
he  experimented,  as  well  as  in  »man,  the  becoming 
chilled,  effected  more  than  a  mere  transient  reduction 
of  temperature ;  it  actually  weakened  the  heat-pro- 
ducing power.  This  Avas  proved  by  its  requiring  a 
longer  time  for  the  animal  to  recover  its  warmth  after 
the  second  exposure  than  after  the  first.  He  states 
also,  that  in  a  severe  winter,  in  which  the  Seine  was 
frozen,  a  young  man  in  attempting  to  cross  it,  broke 
the  ice  and  fell  into  the  water ;  but  being  strong  and 
active,  he  succeeded  in  getting  out.  His  health  did 
not  suffer;  but  for  three  days  he  had  a  continual  sen- 
sation of  cold.  This  was  not  so  simple  an  affection 
of  the  nervous  system  as  a  mere  prolongation  of  a 
strong  impression,  but  it  was  an  alteration  of  func- 
tion— a  diminution  of  the  heat-producing  power.* 

*  Vide — Influence  of  Physical  Agents  on  Life,  by  W.  F.  Ed- 
wards, M.D.,  F.R.S. 


36  CAUSES 

We  hardly  need  refer  to  such  high  authority  for 
facts  like  this  last.  Most  persons  are  conscious,  af- 
ter being  excessively  chilled  and  then  warmed  by  the 
heat  of  a  fire,  that  on  returning  immediately  into  the 
cold  air,  they  for  a  while  experience  more  chilliness 
than'at  theVfirst  period  of  the  previous  exposure.  It 
is  unphilosophical  to  refer  these  first  effects  of  i>eing 
chilled  (or  taking  cold)  to  check  of  perspiration  ;  for 
perspiration,  as  connected  with  the  evaporation  which 
attends  it,  is  physically  a  cooling  process  ;  and  the 
check  of  it  would  immediately  produce  warmth,  were 
it  not  for  the  operation  of  the  principle  above  stated. 

It  is  well  to  add  here  a  word  of  application,  at  a 
time  when  many  exaggerate  the  advantages,  and  over- 
look the  dangers,  of  powerful  baths.  This  delusion 
will  have  its  victims,  especially  during  the  prevalence 
of  Cholera.  Cleanliness  may,  and  it  should  be  pre- 
served, without  making  any  strong  or  durable  im- 
pression, either  of  heat  or  cold.  This  is  the  true 
criterion  of  safe  ablution.  In  addition  to  the  danger 
of  excessive  bathing  to  the  community  in  general, 
there  is  one  which  should  not  be  overlooked  by  those 
who  are  under  Homoeopathic  treatment,  either  for  the 
cure  of  disease  or  for  preparing  their  systems  to  re- 
sist the  epidemic.  Strongly-impressing  baths  dis- 
turb the  action  of  remedies.  Hahnemann  justly  con- 
sidered their  present  effect  as  analogous  to  that  of 
large  doses  of  drugs,  and  their  frequent  repetition,  as 
tending  to  retard  the  cure  of  chronic  diseases.  I 
shall,  under  another  head,  give  some  rules  for  bath: 


OP    CHOLERA.  37 


in<r,   but   at   present   advert   to   other   predisposing 
causes  of  Cholera. 


THE    NIGHT    SEASON. 

IT  has  been  ascertained,  that  the  quantity  of  car- 
bonic acid  produced,  is  less  in  the  night  than  in  the 
day-time.  Whether  this  depends  directly  on  the 
absence  of  the  sun  or  not,  is  not  certainly  known. 
From  the  well  established  relation  between  the  aera- 
tion of  the  blood  and  animal  heat,  considered  in  con- 
nexion with  the  opinion  which  Dr.  Edwards'  experi- 
ments led  him  to  entertain,  that  there  is  less  animal 
heat  evolved  during  sl<eep,  we  may  conclude  that 
sleep  contributes  in  some  measure  to  the  defect  of 
aeration.  Rest  may  be  added,  as  moderate  exercise 
increases  oxygenation.  But  this  has  no  material 
influence  on  the  value  of  the  above-mentioned  fact, 
except  that  it  tends  to  confirm  the  influence  of  night, 
the  usual  season  of  rest  and  of  sleep.  Now  it  has  been 
frequently  stated,  that  the  attacks .  of  Cholera  are 
generally  more  frequent  during  the  night.  At  Smyr- 
na, in  October,  1831,  and  in  some  other  places,  the 
mortality,  it  was  said,  occurred  principally  in  the 
night.  The  French  Royal  Academy  of  Medicine 
stated  in  their  report  that  the  invasion  of  the  disease 
had  generally  taken. place  in  the  night  and  towards 
morning.  Now,  Dr.  Prout  found  that  the  carbonic 
acid  in  the  respired  air,  reached  its  minimum  at  half- 
3 


38  CAUSES 

past  eight  in  the  evening,  and  remained  at  the  mini- 
mum state  till  half-past  three  in  the  morning.  As 
the  effects  of  this  defective ' at"- ration  of  the  blood,  are 
accumulating  during  the  whole  of  this  period,  during 
which  it  remains  at  the  minimum  state,  should  we 
not  expect  that,  in  proportion  as  the  influence  of 
night  predominated  among  the  causes  of  the  disease, 
it  would  manifest  itself  oftener  towards  morning? 
And  is  not  the  principle  analogous  to  that  on  which 
depends  the  more  wide  and  rapid  extension  and  the 
increased  severity  of  Cholera,  and  some  other  malig- 
nant diseases  which  are  connected,  though  less  re- 
markably, with  a  defective  aeration  of  the  blood,  at 
the  close  of  that  season  of  the  year  in  which  this 
function  is  at  its  minimum  ?  A  similar  principle  is 
applied  in  physics,  to  the  explanation  of  the  observed 
time  of  maximum  temperature  both  of  the  day  and 
year. 


DEPRESSING     PASSIONS,    FATIGUE, 
FASTING    AND    ALCOHOL. 

Dr.  Prout  ascertained,  by  direct  experiment,  that 
the  quantity  of  carbonic  acid  produced  during  respi- 
ration is  diminished  by  the  depressing  passions,  or 
even  strong  mental  emotions  of  any  kind ;  by  long-- 
continued and  violent  exercise;  by/c/.v////^.  and  by 
intemperate  habits,  and  even  the  moderate  use  of 
alcoholic  liquors.  It  is  well  known,  that  all  these 
arc  powerful  predisposing  causes  of  epidemic  Cholera. 


OF    CHOLERA.  39 


The  disease  has  been  frequently  favored  by  the 
fatiguing  marches  of  armies,  and  the  privations 
which  they  have  suffered ;  by  the  existence  of  pover- 
ty with  its  attendant  evils,  of  excessive  labor  and 
scanty  food ;  by  violent  anger,  by  the  depressing 
passions,  such  as  the  fear  of  the  disease  itself;  and 
by  intemperate  habits,  and  even  the  moderate  use 
of  alcoholic  liquors.  The  want  of  success  which  has 
generally  attended  the  administration  of  alcohol  in 
this  disease  would  not  of  itself  be  conclusive,  but  it 
may  have  some  weight.  The  foregoing  views  res- 
pecting the  causes  and  nature  of  epidemic  Cholera, 
and  a  knowledge  of  the  specific  action  of  alcohol  in 
diminishing  the  oxygenation  of  the  blood,  in  all  indi- 
viduals, however  temperate  and  healthy,  might  have 
led  us  to  anticipate  that  its  influence  in  predisposing 
to  this  disease,  would  not  be  confined  to  the  broken- 
down  drunkard.  This  inference  from  theory  is  con- 
firmed by  experience.  In  relation  to  that  form  of 
the  disease,  in  which  at  the  height  of  the  epidemic 
in  Vienna,  it  most  nearly  approximated  to  the  per- 
fect type,  and  in  which  the  seizure  was  sudden,  the 
evacuations  almost  or  altogether  wanting,  the  cramps 
severe,  and  the  fatal  termination  in  most  cases  in  a 
few  hours,  it  was  observed  that  a  middle  age,  vigor 
of  constitution,  and  such  a  use  of  gin,  as  had  not 
materially  affected  it,  were  predisposing  causes.* 

*  London  Lancet,  for  June  23d,  1832. 


40  CAUSES 

The  last  is  a  practice  which  diminishes  the  aeration 
of  the  blood,  and  the  two  former  are  circumstances 
under  which,  as  has  often  been  shown,  such  diminu- 
tion can  be  tolerated  with  least  impunity.  In  rela- 
tion to  ardent  spirits,  as  predisposing  to  this  disease, 
mistakes  have  arisen  from  too  wide  a  distinction 
between  drinlcing  and  drunkenness.  These  mis- 
takes would  be  corrected  by  physiological  views. 


•;  ABSTINENCE  FROM  ANIMAL  FOOD. 

Dr.  Fyfe  proved  by  experiment,  that  the  carbonic 
acid  was  reduced  to  nearly  one-half  by  vegetable 
diet.  Now  this  is  the  diet  which  has  predominated 
in  those  countries,  in  those  cities,  and  in  those 
classes  of  society,  in  which  the  disease  has  been 
most  fatal,  whether  in  Asia,  Europe  or  America. 
It  is  true,  some  physicians  have  recommended  vege- 
table food  during  the  epidemic,  interdicting  only 
unripe  vegetables,  and  a  few  kinds  generally  ad- 
mitted to  be  peculiarly  unwholesome.  But  this 
preference  for  vegetable  food  must  proceed  rather 
from  an  incorrect  theory,  and  from  their  experience 
in  other  diseases  supposed  by  them  to  be  analogous, 
than  from  their  experience  or  that  of  the  world,  in 
this  disease.*  In  the  report  published  by  the  au- 

*  Most  species  of  grain,  however,  being  more  easy  of  digestion 
and  containing  more  azote  than  most  other  parts  of  vegetables,  make 
a  nearer  approximation  to  animal  food,  and  are  hence  less  injurious 
than  some  other  vegetable  substances. 


OP    CHOLERA.  41 


thority  of  the  French  Academy,  it  is  affirmed,  that 
during  the  Cholera  at  Calcutta,  "those  who  lived  on 
vegetable  substances  were  first  taken  off;  and  that 
•women  and  children  seemed  to  be  spa'red."  I  quote 
the  whole  passage,  as  the  latter  part  affords  some 
evidence,  that  this  influence  of  vegetable  food  is  not, 
as  some  have  supposed,  referable  merely  to  the  de- 
bility and  consequent  irritability  induced  by  it. 

Moreover,  that  it  was  mode  of  living,  and  not  idio- 
syncrasy, that  rendered  the  Hindoos  so  much  more 
liable  to  the  disease  than  the  English  residents,  may 
be  argued  from  the  fact,  that  the  native  soldiers, 
whose  mode  of  living  was  more  similar  to  that  of  the 
English,  enjoyed  a  similar  degree  of  exemption. 
Indeed,  it  was  every  where  observed,  that  those  who 
subsisted  on  vegetable  food,  were  selected  as  the  first 
victims.  Perhaps  it  may  be  worthy  of  remark,  that 
the  unusual  mortality  in  Paris,  where  at  the  least 
twenty  thousand  of  the  inhabitants  were  carried  off 
in  a  month,  occurred  during  the  season  of  Lent. 
Immediately  after  Easter  the  virulence  of  the  disease 
rapidly  abated.  The  proportion  of  vegetable  food  is 
usually  great  among  a  French  population.  May  not 
the  severe  Cholera  of  Montreal  and  New-Orleans,  in 
1832,  be  cited  as  in  some  degree  examples  of  its 
influence  ?  On  the  ensuing  spring,  the  disease, 
after  its  winter's  sleep,  awoke  in  the  Catholic  city 
of  Havana,  in  the  season  of  Lent.  It  numbered 
among  its  victims  many  of  the  most  respectable  and 
religious  citizens,  and  produced  a  mortality  unpre- 


42  CAUSES 

cedcntcd  in  the  history  of  its  ravages  in  the  western 
hemisphere.*  Were  these  isolated  facts,  they  would 
merit  less  regard.  But  the  influence  of  vegetable 
food,  has  been  generally  observed  to  predispose  to 
Cholera,  and  even  to  epizootics  strongly  resembling 
it;  but  never,  in  any  instance  which  I  have  heard, 

*  Among  other  respectable  individuals  who  fell  victims,  was  the 
Archbishop  of  Havana.  On  some  days  900  are  said  to  have  died 
out  of  a  population  of  about  180,000.  Not  having  access,  ho\ve\er, 
to  official  documents,  I  extract  this  from  the  newspapers,  ;i 
the  following  account  of  the  recommencement  of  the  march  of  the 
disease  in  Louisiana,  nearly  at  the  same  time.  The  following  is 
from  the  Albany  Argus  of  April  15th,  1833.  "The  Louisiana  Re- 
publican, printed  at  Franklin,  in  the  Attakapas  region,  says  that  the 
Cholera  has  begun  to  assume,  in  that  quarter,  a  more  formidable 
appearance.  At  first,  few  cases  proved  fatal,  except  those  which 
occurred  among  the  colored  population ;  persons  of  temperate  habits 
were  seldom  attacked."  [This  shows  the  influence  of  alcohol.] 
"  But  of  late,  citizens  particularly  noted  for  their  temperance  have 
fallen  victims."  [This  shows,  perhaps,  the  combined  effects  of  boat, 
vegetable  diet,  and  fasting.]  The  St.  Martinsville  (Lou.)  Courier, 
of  22d  March,  gives  a  similar  account  of  its  prevalence  in  that  place 
and  its  vicinity.  "As  it  was  nearly  stationary  during  the  winter, 
we  thought  that  the  salubrity  of  our  situation  would  preserve  us  ; 
but  within  the  last  three  weeks,  it  appears  to  have  extended  its 
exterminating  influence,  and  we  have  already  to  deplore  the  loss  of 
several  respectable  inhabitants  of  our  parish,  as  also  a  great  number 
of  slaves."  Now  it  is  worthy  of  notice,  that  the  24th  of  Feb.,  wa» 
the  first  Sunday  in  Lent;  and  it  would  seem  that  the  extension 
of  its  "  exterminating  influence,"  commenced  about  a  week  after- 
wards. "What  intemperance  did  for  the  lower  and  dissolute,  did 
not  fasting  and  vegetable  diet  contribute  to  effect  for  the  higher 
and  religious  classes'!  Those  who  are  better  acquainted  with  their 
habits  can  judge. 


"OF  CHOLERA.  43 

among  animals  exclusively  carnivorous.  I  need  only 
allude  to  the  epizootic  which  prevailed  among  several 
species  of  herbivorous  animals  in  Scotland,  and  to 
the  mortality  among  the  fowls  of  Choisi  near  Paris  ; 
to  their  white  alvine  discharges  ;  and  the  dark  color 
assumed  by  their  combs,  affording,  from  their  trans- 
lucence,  an  index  to  the  color  of  the  blood. 

From  the  effects  of  vegetable  diet  and  abstinence 
from  food,  I  must  believe,  that  a  fast  in  either  of 
these  senses,  during  the  epidemic,  would  tend  to 
aggravate  the  awful  calamity  which  it  might  be 
proposed  for  the  purpose  of  averting ;  yet,  on  the 
other  hand,  as  strong  emotions,  and  especially  the 
depressing  passions,  have  been  shown  to  produce  an 
influence  similar  to  that  of  fasting,  it  is  evident  that  a 
religious  frame  of  mind,  a  calm  and  cheerful  reliance 
on  Divine  Providence,  must  be  among  the  best  pre- 
servatives. During  the  prevalence  of  Cholera,  it 
should  be  considered  a  sacred  duty  to  avoid  fasting, 
except  so  far  as  fasting  is  dictated  by  want  of  appe- 
tite. 


OPPRESSION  OF  THE  DIGESTIVE  ORGANS,  WITH 
FOOD  INDIGESTIBLE  IN  QUALITY  OR  EXCES- 
SIVE IN  QUANTITY. 

Tins  is  another  cause  of  impaired  calorific  func- 
tion, as  well  as  of  Cholera.  During  the  first  stage 
of  a  digestion  rendered  laborious  by  indigestible  food 
or  over-eating,  all  persons,  especially,  those  of  weak 


44  CAUSES 

live  powers,  are  conscious  of  some  degree  of 
chilliness  on  exposure  to  cold.  This,  as  Dr.  Edwards 
has  explained  in  the  cases  before  cited,  is  not  merely 
a  simple  nervous  impression,  but  an  alteration  of 
function,  a  diminution  of  the  power  of  generating 
animal  heat. 

Now  it  is  known,  that  excess  in  eating,  even  in 
the  case  of  wholesome  food,  and  the  use  of  indigesti- 
ble substances,  as  crude  and  flatulent  vegetables, 
clams,  the  meat  of  young  animals,  &c.,  especially 
by  persons  of  weak  digestion,  frequently  disposes  to 
an  attack  of  Cholera.  - 


CROWDED    OR     INSUFFICIENTLY 
VENTILATED    ROOMS. 

THE  air  of  rooms  which  are  occupied  by  too  many 
persons,  or  insufficiently  ventilated,  diminishes  the 
aeration  of  the  blood  and  the  generation  of  animal 
heat,  and  also  predisposes  to  an  attack  of  Cholera. 
It  is  unnecessary  to  cite  any  proofs  of  the  former 
proposition.  Air  deficient  in  oxygen  and  charged 
with  carbonic  acid,  cannot  properly  sustain  the  ca- 
lorific function.  Its  effect  in  predisposing  to  Chole- 
ra, the  history  of  this  epidemic  sufficiently  manifests. 
The  principle  here  referred  to,  is  distinct  from  that 
of  infection.  When  the  disease  has  once  entered  a 
room,  both  principles  co-operate.  But  crowded  and 
ill-ventilated  rooms  not  only  conduce  to  the  commu- 


OF    CHOLERA.  45 


nication  of  the  disease  when  once  admitted,  but  they 
invite  it  to  enter. 

The  occupants  of  basements  seem,  casteris  paribus, 
to  be  more  liable  to  the  disease.  This  may  be  owing 
to  the  combined  effect  of  carbonic  acid  and  humidity, 
and  perhaps  of  the  tendency  of  Cholera  miasm  to 
travel  into  low  places.  That  some  of  the  other 
circumstances  above  enumerated,  exert  on  the  miasm 
a  physical  influence,  which  conspires  with  their 
physiological  influence  on  man,  in  exciting  the  dis- 
ease, is  not  improbable. 


NEGLECT  OF  PERSONAL  CLEANLINESS. 

THE  accumulation  of  cutaneous  filth  sustains  to 
respiration,  animal  heat  and  the  state  of  the  blood, 
and  to  Cholera,  a  relation  similar  to  that  of  the  ten 
other  circumstances  above  considered :  but  its  in- 
fluence is  less  striking.  By  mechanically  obstruct- 
ing the  cutaneous  pores,  filth  must  in  some  measure 
diminish  the  aeration  of  the  blood,  which  is  known  to 
be  effected  in  part  by  the  skin.  There  is  here,  as  in 
the  lungs,  an  absorption  of  oxygen  and  elimination 
of  carbonic  acid.  There  is  in  man,  a  cutaneous  as 
well  as  pulmonary  respiration  ;  though  it  is  less 
remarkable  than  in  frogs  and  other  animals  of  the 
order  batrachia,  which  will  survive  the  loss  of  their 

lungs  longer  than  that  of  their  skin. 
3* 


46  CAUSES 

But  in  man,  the  obstruction  of  the  cutaneous  pores 
is  more  important  in  its  relation  to  the  pulmonary 
than  to  the  cutaneous  respiration,  or  even  to  the  cuta- 
neous perspiration  ;  as  was  intimated  when  treating 
of  the  effects  of  being  chilled.  The  liquid  transpired 
could,  if  suppressed,  be  chiefly  eliminated  by  the 
kidneys  ;  but  although  other  evils  would  ultimately 
result  from  this  retention,  the  first  morbid  effects  of 
obstructing  the  cutaneous  pores,  even  as  it  relates 
to  transpiration,  seem  to  relate  chiefly  to  the  oxy- 
genating and  calorific  function. 


UNGENERALIZED    FACTS. 

Among  the  circumstances  which  physiologists  have 
found  to  diminish  the  quantity  of  oxygen,  there  are, 
in  addition  to  those  which  have  been  enumerated,  a 
few  others,  the  influence  of  which  in  predisposing  to 
this  disease  requires  further  investigation.  These 
are  the  use  of  tea  ;  the  administration  of  nitric  acid  ; 
affecting  the  system  by  a  course  of  mercury  ;  and 
placing  the  body  in  a  posture  which  impedes  respi- 
ration. I  am  acquainted  with  no  general  etiological 
fact  in  relation  to  these,  which  militates  against  the 
foregoing  views ;  and  from  the  evidence  above  ad- 
duced, in  relation  to  agencies  similar  to  these  in  one 
of  their  physiological  relations,  I  believe  that  persons 
by  taking  green  tea,  nitric  acid,  blue  pills  or  calomel, 
would  be  more  liable  to  Cholera. 


OP    CHOLEKA.  47 


On  the  other  hand,  among  the  predisposing  causes 
of  Cholera,  there  are  some,  whose  influence  on  the 
consumption  of  oxygen  requires  further  investigation. 

Many  cases  of  Asiatic  Cholera  have  been  produced 
by  cathartics.  I  have  known  several  instances.  I 
might  give  a  plausible  explanation  by  which  such 
facts  could  be  brought  under  the  above  law ;  but  I 
prefer  abstaining  from  all  hypothesis. 

In  the  same  class  of  ungeneralized  facts,  I  shall  for 
similar  reasons,  place  the  influence  of  certain  changes 
in  the  hygrometric,  barometric  and  electrical  states 
of  the  atmosphere.  These  are  so  generally  connected, 
that  simultaneous  and  repeated  observations,  and  a 
nice  discrimination,  would  be  requisite  to  determine 
their  separate  influences  even  on  cholera.  In  August, 
1832, 1  observed  at  two  different  times,  a  considerable 
depression  of  the  barometer  and  elevation  of  the 
dewpoint,  and  at  both  times,  there  was,  I  believe,  a 
sudden  and  considerable  increase  of  the  disease  both 
in  Albany  and  Schenectady.  As  the  epidemic,  having 
commenced  at  different  times  in  these  two  neighbor- 
ing cities,  was  not  in  the  same  stage,  these  simulta- 
neous changes  must  be  attributed  to  a  meteorological 
influence.  If  humidity  was  the  cause,  humidity  as 
detected  by  the  hygrometer,  seemed  to  have  more  in- 
fluence than  rain.  That  the  effect  depended  partly 
on  an  electrical  change  preceding  a  storm,  is  not  im- 
probable. Finally,  there  are  many  agents  whose  in- 
fluences both  on  the  consumption  of  oxygen  and  the 
production  of  Cholera  are  alike  unknown.  If,  as  ap- 


48  CAUSES 

pears  from  numerous  considerations  above  stated, 
there  is  any  law  connecting  these  influences,  then  ex- 
periments for  determining  the  effect  of  these  agents 
on  respiration,  might  lead  to  important  practical  ap- 
plications in  relation  to  the  prevention,  if  not  to  the 
treatment  of  the  disease.  In  applying  the  results, 
however,  regard  should  be  had  to  the  difference  be- 
tween the  immediate  and  remote  effects  on  respira- 
tion ;  these  are  frequently  opposite. 


RECAPITULATION, 

Without  the  aid  of  any  mere  hypothesis,  I  have 
shown,  that  there  is  a  remarkable  correspondence  be- 
tween certain  classes  of  physiological  and  aetiological 
facts,  in  relation  to  Cholera.  This  correspondence  is 
interesting  on  account  of  the  dependence  of  animal 
heat  and  the  florid  color  of  arterial  blood  on  respi- 
ration, considered  in  connexion  with  the  fact,  that  in 
an  advanced  state  of  dangerous  cases  of  e^y  variety 
of  this  disease,  and  in  an  early  stage  of  the  severer 
varieties,  no  pathological  phenomena  are  more  con- 
stant, than  a  dark  color  of  the  blood  and  a  temperature 
below  the  normal  standard. 

As  a  large  proportion  of  the  occasional -or  predis- 
posing causes  are  in  a  great  measure  under  the  con- 
trol of  man,  a  statement  of  these  and  of  the  scientific 
evidence  of  their  influence,  will*  tend  to  inspire  nope 
and  promote  safety. 


OF    CHOLERA.  49 


I  have  shown  that  physiology  concurs  with  general 
experience,  in  proving  the  following  to  he  the  prin- 
cipal predisposing  causes  of  Cholera  :  viz.,  1st,  hot 
climates  and  hot  seasons ;  2d,  becoming  chilled  by 
cold  air  or  by  cold  bathing ;  3d,  the  night  season  ; 
4th,  fear  and  other  depresswg  emotions  ;  5th,  vio- 
lent and  excessively  fatiguing  exercise;  6th,  total 
fasting,  i.  e.  abstinence  from  all  food  ;  7th.  partial 
fasting,  i.  e.  abstinence  from  animal  food  ;  8th,  op- 
pressing the  stomach  with  food  indigestible  in  qua- 
lity or  excessive  in  quantity  ;  9th,  the  moderate  as 
well  as  intemperate  use  of  alcoholic  drinks  •  10th, 
crowded  or  insufficiently  ventilated  rooms ;  and 
llth,  neglect  of  personal  cleanliness. 

The  order  in  which  these  are  enumerated,  has  no 
reference  to  their  relative  potency,  hut  to  their  natu- 
ral affinities. 


60  INFECTION 


CHAPTER     III. 

DOCTRINE    OF   INFECTION 

WITH     REFERENCE     TO     THIS     DISEASE. 


ERROR  OF  THE  PREVALENT  DOCTRINE. 

An  opinion  extensively  entertained  by  the  profes- 
sion, is,  that  there  is  a  certain  class  of  diseases,  in- 
cluding small  pox,  measles,  scarlatina  and  hooping 
cough,  which  an  individual  may  take  on  coming  near 
a  patient  affected  with  them,  although  the  interme- 
diate air  be  pure ;  and  that  there  is  another  class  of 
diseases,  including  plague,  yellow  fever,  typhus 
fever,  dysentery  and  cholera,  which  an  individual 
cannot  take,  unless  the  intermediate  air  between  him 
and  the  patient  is  impure,  and  that  he  takes  these 
from  the  air,  and  not  by  any  specific  poison  derived 
either  directly  or  indirectly  from  the  patient.  The 
former  class  of  diseases,  they  denominate  contagious  ; 
the  latter  class,  infectious, 

But  in  both  cases,  the  disease  is  communicated 
through  the  air,  and  in  consequence  of  its  contami- 
nation ;  and  in  both  cases  by  a  specific  poison,  else 
the  same  kind  of  disease  as  that  with  which  the  first 
patient  was  affected  would  not  be  reproduced.  These 
classes  of  disease,  when  communicated  through  the 
air,  differ,  not  in  the  principle  or  mode  of  communi- 


OP    CHOLERA.  51 


cation,  but  in  the  quantity   or  dose  of  the  poison, 
which  is  requisite  for  reproducing  the  disease. 

The  terms  contagion  and  infection,  aa  now  exten- 
sively used  in  a  technical  sense,  serve  only  to  conceal 
the  want  of  precise  ideas,  and  the  defects  of  a  false 
mode  of  reasoning.  Whence  the  disputes  and  hesi- 
tation of  learned  academies,  and  of  the  medical  world 
generally,  in  relation  to  this  subject  ?  In  my  opinion, 
this  confusion,  disagreement  and  indecision  arise 
from  not  viewing  the  subject  in  a  mathematical  point 
of  view,  that  is,  in  its  relation  to  the  science  of  quan- 
tity. The  popular  mind  is  prone  to  inquire  about  the 
existence  of  certain  things  or  entities,  rather  than 
their  quantitative  relations.  It  asks,  is  there  infec- 
tion in  this  disease  or  in  that  1  It  does  not  think  to 
inquire,  whether  there  is  more  or  less  infecting  power. 
It  does  not  suspect  that  this  is  the  only  difference  in 
many  diseases  in  regard  to  their  power  of  propagating 
themselves.  The  medical  mind,  perhaps  from  defi- 
ciency of  mathematical  training,  is  extensively  infect- 
ed with  this  same  intellectual  vice.  Physicians,  in- 
stead of  recognizing  degrees  in  the  infecting  power, 
generally  found  their  distinctions  on  modes  and  media 
of  transmission.  Again,  instead  of  recognizing  a 
great  diversity,  as  they  would  if  they  had  hit  on  the 
true  principle  of  distinction,  they  assume  that  all  ex- 
cept a  few  diseases  are  incommunicable  under  any 
circumstances  ;  and  through  those  that  they  acknow- 
ledge capable  of  propagation,  they  arbitrarily  draw  a 
single  line,  and  denominate  the  whole  group  on  one 


52  INFECTION 


side  of  that  line  contagious,  and  the  whole  group  on  the 
other  side  infectious.  They  have  not  yet  perceived 
that  what  they  call  infection,  considered  as  a  property 
of  the  disease,  is  merely  the  contagious  property  in 
less  intensity.  For  convenience,  I  shall  use  the  terms 
infection  and  infectious  in  their  most  comprehensive 
sense,  which  embraces  all  modes  of  communication. 


INDEFINITENESS    OF    THE    PROBLEM. 

To  ask  whether  Asiatic  Cholera  is  infectious,  is 
like  asking  whether  diluted  alcohol  is  an  intoxicating 
drink.  Is  diluted  alcohol  an  intoxicating  drink,  or  is 
it  not  '.*  Does  not  every  one  perceive,  that  for  the 
solution  of  this  problem,  the  requisite  data  are  not 
given  in  the  question ')  It  is  indefinite  in  three  re- 
spects ;  viz.,  first,  as  to  the  degree  of  dilution  of  the 
alcohol ;  secondly,  as  to  the  quantity  to  be  taken ; 
and  thirdly,  as  to  the  susceptibility  of  the  drinker  to 
its  intoxicating  influence.  One  part  of  alcohol  diluted 
with  ten  thousand  parts  of  water,  is  not  an  intoxi- 
cating drink,  in  any  quantity  which  the  stomach  can 
retain:  one  part  of  alcohol  diluted  with  one  hundred 
parts  of  water,  is  not  an  intoxicating  drink,  unless 
taken  in  enormous  quantities,  or  by  persons  highly 
susceptible. 

The  problem,  in  regard  to  the  infectiousness  of 
Cholera,  is  of  a  similar  nature,  and  is  to  be  solved  by 
a  reference  to  precisely  the  same  three  conditions, 
viz.  dilution,  quantity  and  susceptibility. 


OP    CHOLERA.  53 


INFLUENCE    OF    DILUTION. 

If  several  Cholera  patients  should  at  the  same 
time  occupy  the  same  small  and  ill-ventilated  room, 
the  air  of  that  room  would,  after  some  time,  become 
so  charged  with  the  miasm,  as  to  be  capable  of  com- 
municating Cholera  to  other  occupants,  provided  that 
by  their  constitution,  their  state  of  health,  their  neg- 
lect of  regimen  aiyl  of  prophylactic  remedies,  they 
possessed  a  certain  degree  of  susceptibility  to  the 
disease.  To  them,  the  disease  would  be  infectious, 
in  this  concentrated  state  of  the  morbific  miasm.  On 
the  other  hand,  if  there  were  only  one  patient  in  a 
large  and  well-ventilated-room,  the  respiration  of  its 
air  during  the  same  length  of  time,  and  by  individuals 
having  the  same  predisposition,  might  be  perfectly 
safe,  and  would  certainly  be  attended  with  little 
danger  as  compared  with  that  in  the  small,  close  and 
crowded  room  above-mentioned.  What,  in  a  more 
concentrated  state,  was  a  poison,  becomes  compara- 
tively innoxious  by  dilution.  If  we  admit  the  pos- 
sibility of  taking  Cholera  under  these  last  circum- 
stances— if  we  say  that  even  in  such  a  room  it  is  pos- 
sible that  Cholera  may  to  some  persons  prove  infec- 
tious, our  statement  is  liable  to  be  misunderstood  and 
misapplied.  One  will  say,  Cholera  is  then  infectious, 
like  small-pox.  This  would  be  a  gross  exaggeration, 
and  one  which  it  is  important  to  prevent ;  inasmuch 
as  it  would  deter  many  from  giving  the  requisite  at- 
tention to  the  sick,  and  also  excite,  among  those  not 


54  INFECTION 


yet  attacked,  an  alarm  that  would  increase  their  sus- 
ceptibility. The  miasm  of  small-pox  is  one  that 
operates  in  a  much  more  diluted  state  than  that  of 
Cholera,  and  requires  no  peculiar  susceptibility  ex- 
cept that  naturally  possessed  by  persons  who  have 
not  been  vaccinated.  Such  persons  by  going  near  a 
small-pox  patient,  even  in  a  large  and  well-ventilated 
room,  would  be  in  great  danger  of  taking  the  disease. 
The  danger  of  this  in  case  of  exposure  to  a  Cholera 
patient  under  the  same  circumstances,  would  be  corn- 
peratively  trifling. 

Again,  even  the  miasm  of  small-pox  can,  by  dif- 
fusion in  the  open  air,  be  so  diluted,  as  to  lose  en- 
tirely its  poisonous  property,  and  become  incapable  of 
producing  the  disease.  Still  more  easily  does  this 
take  place  in  case  of  the  Cholera  Miasra.  We  have 
seen,  that  for  weeks  it  confined  itself  to  the  hospitals 
at  Staten-Island,  without  passing  beyond  their  com- 
mon enclosure  to  affect  the  village  in  which  they  are 
situated.  In  1853 — 54  there  have  been  similar  in- 
stances in  the  same,  locality. 

For  security  from  infection  by  Cholera  miasm,  it 
must  have  a  certain  degree  of  dilution.  Among  the 
practical  applications  to  be  made  of  this  doctrine, 
we  may  mention  the  importance  of  ventilation,  of 
using  as  large  rooms  as  possible  for  Cholera  patients, 
and  allowing  as  few  patients  as  possible  to  be  confined 
in  the  same  room.  Ventilation  and  washing  are  the 
only  requisites  for  the  purification  of  rooms  which 
have  been  occupied  by  Cholera  patients.  There  is 


OF    CHOLERA.  55 

no  evidence  that  chlorine  or  chloride  of  lime  has  the 
slightest  influence  on  this  infecting  miasm  itself; 
and  the  fumigation  of  the  sick-room  would  be  decid- 
edly prejudical,  both  to  the  patient  and  his  attendants. 
In  addition  to  the  direct  deleterious  action  of  the  gas 
on  the  system,  it  would  interfere  with  the  salutary 
action  of  medicines  and  prophylactics. 


.       INFLUENCE     OF    DOSE. 

Having  considered  the  influence  of  dilution,  I  shall 
proceed  to  that  of  quantity.  If  any  poison  is  diluted 
to  that  degree  in  which  it  just  begins  to  lose  its 
power  of  acting  as  a  poison,  in  a  certain  dose,  it  will 
still  act  as  a  poison  in  a  larger  dose,  or  (what  is  nearly 
equivalent  in  practical  effect)  in  numerous  and  fre- 
quently repeated  doses,  the  aggregate  of  which  is  a 
very  large  quantity. 

The  Cholera  miasm  observes  the  same  law.  A 
room,  occupied  by  Cholera  patients,  may  be  so  large 
and  well-ventilated,  that  a  susceptible  individual 
might  be  perfectly  safe  in  it  for  three  hours,  but  not 
for  thirty.  During  the  latter  period,  he  would  inhale 
ten  times  as  much  air  slightly  impregnated  with  the 
miasm.  Allopathic  physicians  have  frequently  seen 
the  mischievous  and  even  fatal  effects  of  mercury  and 
arsenic  in  what  they  call  small  doses,  administered 
by  them  for  a  considerable  length  of  time. 

Still  there  is  nothing  on  earth  which  is  a  poison, 
irrespective  of  concentration  and  dose.  We  cannot 


f)G  INFECTION 


consider  the  Deity  as  the  Author  of  any  thing  which 
is  poisonous,  i.  e.  destructive,  in  its  very  essence. 
Read  the  impressive  language  of  Ilahnemann.  "When 
He,  the  All-bountiful,  created  iron,  He  left  it  to  the 
free  choice  of  the  children  of  men,  to  fashion  it  either 
into  the  deadly  dagger,  or  the  peaceful  ploughshare, 
to  slay  or  to  support  their  race.  Ah,  how  much 
happier  for  them,  did  they  employ  all  His  gifts  for 
good !  So  would  they  fulfil  His  will  and  the  end  of 
their  being.  We  cannot  charge  an  all-loving  Provi- 
dence with  the  crimes,  that  men  have  committed  in 
abusing  the  administration  of  terribly  powerful  drugs, 
by  giving  them  in  enormous  doses,  and  in  improper 
cases." 

Such  were  the  elevated  sentiments  that  animated 
the  man,  who  will,  in  all  future  times,  be  remembered 
as  the  first  discoverer  of  a  method,  by  which  the 
noxious  properties  of  the  most  virulent  poisons  may 
be  removed,  whilst  their  curative  properties  are 
retained  or  heightened.  The  success  of  this  phar- 
maceutic  method  depends  greatly  on  that  minute 
division  which  is  effected  by  a  certain  diluting  pro- 
cess ;  yet  the  first  object  in  the  mind  of  its  discoverer 
was  the  reduction  of  dose.  He  aimed  to  diminish 
the  quantity  of  a  crude  allopathic  drug  to  such  a 
degree,  that  it  should  cease  to  be  a  poison,  that  is, 
become  a  medicine  fit  for  homoeopathic  use.  I  have 
been  insensibly  led  to  speak  of  this  method,  when 
considering  the  effect  of  inhaling  a  greater  or  less 
quantity  of  air  impregnated  with  Cholera  miasm. 


OP    CHOLKRA.  57 


Whether  Cholera  is  or  is  not  infectious,  depends 
not  only  on  the  degree  in  which  the  air  is  impregnated 
with  the  miasra,  but  upon  the  quantity  of  the  air  in- 
haled, and  consequently  upon  the  length  of  time 
during  which  it  is  continuously  respired. 

I  will  make  another  application  of  these  views 
relative  to  the  latter  topic.  Wherever  it  is  practi- 
cable, there  should  be  a  provision  for  the  occasional 
relief  of  nurses  ;  so  that  no  one  should  be  required 
to  spend  the  whole  day,  much  less  day  and  night, 
in  the  sick-chamber. 

For  making  such  a  desirable  arrangement,  the 
homoeopathic  system  offers  peculiar  advantages.  In 
the  first  place,  homoeopathic  families  will  have  fewer 
cases  of  Cholera ;  secondly,  these  cases  will  be  of 
much  shorter  duration,  i.  e.  will  sooner  terminate  in 
health  ;  and  thirdly,  they  will  require  less  nursing  in 
proportion  to  their  number  and  duration.  Every 
family  which  has  enjoyed  homoeopathic  practice,  knows 
what  an  amount  of  nurse-labor  is  dispensed  with  by 
avoiding  external  'applications,  to  say  nothing  of 
evacuants,  which  in  case  of  Cholera  the  disea&e  itself 
often  supplies,  as  if  to  give,  at  the  same  time,  a 
specimen  and  a  reproof,  of  allopathy  carried  to  per- 
fection. 


58 


INFECTION 


{INFLUENCE     OF    SUSCEPTIBILITY. 

But  not  only  does  Cholera  fail  to  be  infectious,  un- 
less there  is  a  sufficient  concentration  of  the  poison 
in  the  air,  and  a  sufficient  quantity  of  this  air  re- 
spired ;  but  it  also  fails  to  be  infectious,  unless  there 
is  a  peculiar  predisposition  or  susceptibility  in  the 
person  exposed.  .  Some  possess  an  immunity,  from 
the  very  nature  of  their  constitutions,  others  by  the 
good  state  of  their  health  at  the  time,  others  by  the 
judicious  regulation  of  their  diet  and  regimen,  and 
others  in  consequence  of  having  taken  the  homoeo- 
pathic prophylactics,  i.  e.  preventive  medicines. 

What  I  have  to  say  hereafter  in  regard  to  the  suc- 
cess of  prophylactic  and  therapeutic  measures,  is 
calculated  to  confirm  the  confidence  and  hopes  of  the 
homoeopathic  members  of  the  community  ;  and  what 
I  have  said  in  regard  to  infection,  is  also  calculated  to 
allay  anxiety.  When  the  public  are  apprized,  that,  in 
the  last  travel  of  the  Cholera,  the  first  place  in  which 
it  appeared  on  this  continent,  was  not  in  any  filthy 
street,  of  any  large  city,  but  in  a  hospital  into  which 
Cholera  patients  had  been  recently  introduced,  it 
will  be  difficult  to  persuade  them,  that  the  vicinity 
of  those  already  affected  with  Cholera,  has  not  some 
influence  in  propagating  the  disease.  The  anxiety 
which  such  a  fact  is  calculated  to  excite,  is  not  allay- 
ed by  the  disputes  of  the  faculty  in  regard  to  the 
question  whether  the  disease  is,  or  is  not  contagious, 
nor  by  any  distinctive  names,  expressing  merely  the 
modes  of  communication.  The  true  solace  is  to  be 


OF    CHOLERA.1  59 


derived  from  a  consideration  of  the  various  degrees 
of  infecting  power,  and  the  feebleness  of  that  of 
Cholera  ;  and  the  true  security  is  to  be  derived  from 
an  examination  and  application  of  the  principles,  on 
which  this  infecting  power  is  still  farther  enfeebled, 
so  as  to  become  scarcely  appreciable,  and  from  those 
prophylactic  measures  which  diminish  or  remove  in- 
dividual susceptibility. 

It  is  probable,  that  almost  all  diseases  are  more  or 
less  communicable  to  individuals  who  have  a  peculiar 
susceptibility  to  their  respective  influences.  Some 
of  these  diseases,  as  small-pox,  are  generated  by  the 
reception  of  inconceivably  minute  doses  of  the  morbid 
product.  Small-pox,  again,  is  an  example  of  a  dis- 
ease which  requires  no  special  susceptibility  ;  none 
which  is  not  naturally  possessed  by  almost  all  per- 
sons previously  to  vaccination  ;  whereas  a  majority 
escape  Cholera,  even  when  they  are  most  fully  ex- 
posed to  it,  and  pay  no  special  attention  to  diet  or 
regimen. 

In  the  case  of  cholera,  as  well  as  of  most  other  dis- 
eases, the  liability  to  infection  depends  vastly  more 
upon  the  peculiar  susceptibility  of  the  individual, 
than  upon  the  degree  of  exposure.  When  Cholera  is 
introduced  into  a  city,  a  majority  of  its  inhabitants  may 
have  symptoms  which  mark  its  presence  in  the  atmos- 
phere ;  but  only  a  small  proportion  usually  take  the 
disease,  however  intimate  their  communication  with 
the  sick ;  and  of  those  who  do  become  affected  with 
it,  there  is  a  large  majority  who  have  had  no  obvious 


60  INFECTION 


and  direct  communication  with  persons  laboring  un- 
der the  disease. 


ROUTES  AND  MODES  IN  WHICH  THE 
CHOLERA  TRAVELS. 

In  its  progress  from  one  country  to  another,  and 
from  city  to  city,  it  oftener  selects  the  great  thorough- 
fares of  men,  and  especially  rivers.  Its  preference 
of  low  situations,  and  especially  of  the  shores  of 
rivers  and  other  bodies  of  water,  appears  however 
not  to  be  entirely  owing  to  human  intercourse.  In 
1832, 1  observed  that  nearly  all  the  cases  at  the  com- 
mencement of  the  epidemic  in  Schenectady,  were  for 
some  time  in  a  retired  part  of  the  town  near  the  Mo- 
hawk, a  river  not  used  for  navigation.  At  other 
times,  the  disease  travels  across  dry  regions,  and 
seems  to  pass  from  city  to  city,  independently  of  hu- 
man intercourse.  Cholera,  then  travels  by  two  me- 
thods ;  viz.,  with  men  as  vehicles,  and  without  any 
obvious  and  visible  vehicles  of  transportation  :  it 
sometimes  goes,  at  other  times  it  is  carried. 

During  its  prevalence  in  any  part  of  a  country  or 
of  a  city,  some  degree — more  or  less  slight — of  a 
widely  diffused  epidemic  influence,  is  usually  mani- 
fested, by  a  tendency  to  diseases  somewhat  similar, 
provided  the  season  of  the  year  is  favorable  to  the 
spread  of  cholera. 

As  to  quarantine  regulations,  we  can  rarely  expect 


OF    CHOLERA.  61 


from  them  more  than  some  postponement  of  the  in- 
vasion. Even  this  will  justify  their  rigorous  enforce- 
ment. The  disease  is  propagated  partly,  though 
not  exclusively,  by  infection. 


CHAPTER    IV. 

HYGIENE  AND  PROPHYLAXIS. 


ARTICLES  WHICH  SHOULD  NOT  BE  USED  BY  PERSONS 
WHO  ARE  TAKING  HOMOEOPATHIC  MEDICINES, 
EITHER  DURING  THE  PREVALENCE  OF  CHOLERA 
OR  AT  OTHER  TIMES. 

1st.  Raw  vegetables — such  as  celery,  lettuce,  &c. ; 

2d.   Unripe,  or  sour  fruits,  and  acids  in  general ; 

3d.  Food  which  has  any  medicinal  qualities — such 
as  onions  and  tomatoes,  and  bread  prepared  with  soda  ; 

4th.  Coffee,  green  tea,  and  distilled  and  fermented 
liquors  ; 

5th.  Condiments  (except  salt),  as  vinegar,  pickles, 
pepper,  spices  and  mustard ; 

6th.  Camphor,  hartshorn,  cathartics,  herb-teas,  and 
other  medicines  (whether  external  or  internal)  except 
those  prescribed  by  the  physician ; 

7th.  Tobacco  in  great  quantities,  especially  by 
chewing  ;  and  in  any  quantity  unless  the  individual 
has  been  long  accustomed  to  it. 

4 


62  'PREVENTION 


None  of  the  forbidden  articles  (except  coffee,  and 
camphor,  and  other  medicines),  need  to  be  suddenly 
and  totally  abandoned,  if  the  individual  has  been 
long  accustomed  to  them.  In  that  case,  he  may,  un- 
less forbidden  by  his  physician,  use  them,  though  in 
great  moderation.  Great  and  sudden  changes  in  re- 
gard to  the  use  of  condiments,  should  not  be  made 
after  the  epidemic  has  actually  commenced  in  the 
place.  Let  the  reform  commence  earlier. 


HYGIENIC  RULES  IMPORTANT  TO  BE  OBSERVED  BY 
PERSONS  IN  GENERAL  DURING  THE  PREVALENCE 
OF  CHOLERA,  AND  USEFUL  AT  ALL  OTHER  TIMES.* 

1st.  Use  warm  clothing,  and  in  cool  or  changeable 
weather,  flannel ;  but  put  a  cotton  or  silk  garment 
under  it,  unless  you  have  been  accustomed  to  flannel 
next  the  skin. 

2d.     Avoid  taking  cold,  or  becoming  chilled. 

3d.  Use  no  cold,  nor  hot,  nor  even  tepid  baths  ; 
but  use  cool  baths,  those  which  feel  like  a  summer 
breeze,  or  sponge  the  body  with  water  of  such  a  tem- 
perature. This,  with  different  individuals  and  dif- 
ferent modes  of  using  the  water,  may  range  from  75° 
to  80°  Fahrenheit. 

4th.  Remain  in  the  water  not  longer  than  a  minute  ; 
and  wash  and  wipe  yourself  dry  as  soon  as  possible  ; 
and  if  in  the  least  chilly,  put  on  extra  clothing. 

*  The  imperative  form  ia  used  her*  for  brevity. 


OF    CHOLERA.  63 


Use  this  ablution  once  a  week,  or  twice  in  summer, 
and  wash  the  feet  and  other  more  sweaty  parts  of  the 
body  dally. 

5th.  Endeavor  to  encourage  good  temper,  hope  and 
cheerfulness,  in  yourself  and  others. 

6th.  Use  moderate  and  even  active  exercise,  but 
avoid  great  fatigue. 

7th.  Avoid  all  kinds  of  fasting,  when  there  is  ap- 
petite.* 

8th.  Let  the  diet  consist  partly  of  animal  food,  and 
partly  of  good  bread  or  some  other  preparation  of 
wheat  flour. t  Use  a  good  proportion  of  fresh  beef, 
mutton,  venison,  or  fowls,  and,  if  it  agrees  with  the 
stomach,  soup  made  of  one  of  these  meats.  Fish, 
eggs,  good  milk,  butter,  sugar,  and  molasses,  are  not 
hurtful  to  persons  in  general,  when  used  in  moderation, 
and  with  a  due  proportion  daily  of  some  of  the  meats 
above-mentioned. 

9th.  Avoid  all  indigestible  food,  every  thing  which 
you  have  found  to  oppress  your  stomach,  whether  it 
be  cabbage,  turnip,  or  other  succulent  vegetables, 
and  especially  fibrous  vegetables  and  fibrous  fruits, 
as  some  kinds  of  radishes  and  pine-apples,  also  fresh 
bread,  rich  pastry,  old  or  toasted  cheese,  m£at  too 
fatty,  veal  or  othei?  young  meats,  sausages,  pork, 
geese,  lobsters,  shell-fish,  eels  or  other  fish  which 

*  I  will  not  deny  that  any  man  has  a  right  to  punish  himself  by 
abstaining  from  hurtful  luxuries  ;  but  he  has  no  right  to  punish 
himself  by  injuring  his  health. 

t  This  last,  possessing  considerable  azote,  has  some  chemical 
similarity  to  animal  food. 


64  PREVENTION 


have  not  both  fins  and  scales.  The  articles  enumerated 
in  this  paragraph  are  of  doubtful  character  for  most 
dyspeptics  at  all  times,  and  for  most  persons  when 
Cholera  prevails. 

10th.  Eat  with  moderation  :  take  care  not  to  over- 
load the  stomach  with  food  of  any  kind. 

llth.  Masticate  the  food  throughly.  If  possible 
observe  regular  and  early  hours  for  eating  and  sleep- 
ing. Avoid  late  suppers  :  but  if  compelled  to  defer 
the  evening  meal  till  a  late  hour,  eat  sparingly. 

12th.  Drink  water,  cocoa,  pure  unspiced  chocolate, 
toast-water,  barley-water,  or  weak  black  tea. 

13th.  Avoid  as  far  as  possible  all  alcoholic  drinks, 
whether  distilled  or  fermented,  but  especially  the 
former.  Use  neither  coffee  nor  green  tea. 

14th.  Keep  your  room  properly  ventilated,  but  in 
such  a  manner  as  not  to  expose  yourself  to  currents 
of  air  when  sitting  still. 

15th.  Do  not  continue  long  in  small  rooms  that 
are  crowded  with  people. 

16th.  If  practicable,  avoid  sleeping  in  basements, 
or  with  many  persons  in  the  same  room. 

Peculiarities  of  constitution  and  inveterate  habits, 
and  the  disadvantages  of  making  great  and  sudden 
changes  after  the  commencement  of  the  epidemic, 
will  justify  some  modification  in  the  above  rules  by 
some  individuals.  In  food,  some  concessions  must  be 
made  to  taste. 


OF    CHOLERA.  65 


PROPHYLACTICS. 

The  homoeopathic  preventives  of  Cholera  are  Cu- 
prum-met all  icum,.  and  Veratrum  album,  prepared 
according  to  the  homoeopathic  method,  and  taken  al- 
ternately in  doses  of  two  or  three  pellets  once  or 
twice  a  week.  The  globules  may  be  placed  on  the 
tongue,  and  allowed  to  dissolve  in  the  mouth,  and 
then  swallowed. 

Wherever  it  is  practicable,  a  homoeopathic  phy- 
sician should  be  consulted;  as  one  of  these  remedies 
would  in  some  cases  be  preferable  to  the  other.  He 
could  decide  which. 

The  method  -which  Hahnemann  recommended,  and 
which  many  employed  with  success,  was  to  take  glo- 
bules medicated  with  the  30th  dilution  of  Cuprum, 
then  wait  one  week,  and  take  the  similarly  medicated 
globules  of  the  30th  of  Veratrum ;  then  after  a 
week,  the  Cuprum,  and  so  on.  Others  have  used, 
with  similar  success,  the  third  dilution  of  each,  at 
intervals  of  half  a  week.  This  may  be  used  by  those 
who  cannot  obtain  the  thirtieth  ;  but  let  no  one  ven- 
ture upon  the  use  of  the  copper  of  the  drug  stores, 
nor  the  crude  colored  tincture  of  Veratrum,  even  of 
the  homoeopathic  pharmacies. 

To  those  who  are  not  very  strict  in  their  homoeo- 
pathic regimen,  it  might  be  well  to  take  «ach  medi- 
cine once  a  week,  i.  e.  alternately  at  intervals  of  three 
or  four  days.  Take  the  medicine  in  the  morning  on 
rising,  an  hour  before  breakfast ;  or,  if  at  another 


66  PREVENTION 


time,  take  nothing  in  the  mouth,  except  pure  water, 
within  an  hour  after  taking  the  medicine. 

When  a  family  is   to  be  protected,  we  might  dis- 
solve five  or  six  pellets  of  the  12th^of  Veratrum  in  a 
gill  of  clean  cold  water,  and  give  each  member  one, 
two  or  three  tea-spoonfuls,    according    to  the  age. 
Then  after  waiting  three  days,  use  the  thirtieth  of 
Cuprum  in  the  same  dose  and  manner  ;  then  wait 
three  days,  and  give  the  thirtieth  of  Veratrum  in  the 
same  dose  and  manner.     Afterwards  alternate   the 
thirtieth  of  each  in  solution  as  before  described,  and 
at  the   same  intervals.     I  advise  commencing  with 
the  Veratrum,  because  Cholera  oftener  requires  Vera- 
trum,  at   least  in   the  male  sex.     Camphor  is  too 
transient  in  its  action  to  be  of  any  use  as  a  prophy- 
lactic :  besides  it  would  interfere  with  other  medi- 
cines.    Persons  who  may  be  so  circumstanced  as  to 
think  it  best  to  carry  it  in  their  pockets,  to  have  it 
ready  in  case  of  attack,  should  keep  it  very  tightly 
corked,  and,  unless  attacked,  should  not  use  it,  even 
by  smelling,  when  they  have  been  taking  a  prophy- 
lactic. 

In  1832,  prophylactics  were  thought  to  have  saved 
thousands  ;  and  some  denied  that  any  who  had  em- 
ployed them  had  fallen  victims  to  the  disease.  I 
have  evidence,  though  not  in  the  circle  of  my  own 
practice,  that  in  this  city  in  1849,  there  were  some 
results  not  corroborative  of  the  latter  statement, 
— a  statement  from  which  some  might  presume,  that 
there  was  complete  safety  in  relying  on  preventives, 


OF    CHOLERA.  67 


even  when  selected  without  reference  to  the  peculiar 
tendencies  of  each  individual.  But  I  am  confident 
that  a  discriminating  treatment  of  premonitory 
symptoms,  according  to  the  principles  and  practice 
recommended  in  this  book  was  invariably  preventive 
of  any  fatal  attack. 


CHAPTER    V. 

HISTORY   OF    TREATMENT, 

OR 

STATISTICAL   PROOFS  OF   THE  SUCCESS  OF 
HOMCEOPATHY  IN  CHOLERA. 


PRELIMINARY    REMARKS. 

A  vast  number  of  remedies  and  modes  of  allopathic 
treatment  have  enjoyed  ephemeral  reputation,  have 
been  lauded,  rejected,  revived,  and  again  rejected. 
This  may  be  partly  explained  by  the  fact,  that  medi- 
cines and  methods  employed  toward  the  close  of  the 
epidemic  in  any  place,  acquire  an  undue  reputation, 
because  the  disease  is  usually  at  that  period  less 
malignant  and  fatal.  The  physician  not  appreciating 
this,  publishes  his  specific  in  good  faith  ;  but  it  utterly 
fails  with  those  who  subsequently  try  it  in  a  different 
place,  in  any  stage  of  the  epidemic  in  which  nature 
is  not  nearly  competent  to  the  cure.  There  is  no 
plan  of  treatment  agreed  upon,  even  by  one-fourth  of 


to  HISTORY 

the  allopathic  physicians,  and  very  little  confidence 
in  allopathic  Cholera  practice  in  general,  among  most 
of  the  best  informed  of  that  school.  An  able  allo- 
pathic author  who  practised  in  1831  and  1832,  in 
England,  where  homoeopathy  was  then  unknown, 
says,  "  If  the  balance  could  be  fairly  struck,  and 
the  exact  truth  ascertained,  I  question  whether  we 
should  find  that  the  average  mortality  from  Cholera 
in  this  country,  was  any  way  disturbed  by  our  craft. 
Excepting  always  the  cases  in  which  preliminary 
diarrhoea  was  checked,  just  as  many,  though  not  per- 
haps the  very  same  individuals,  would,  probably,  have 
survived,  had  no  medication  whatever  been  prac- 
tised." * 

A  friend  asks  me — How  will  you  treat  the  Cholera  ? 
I  answer,  homoeopathically.  I  perceive  he  almost 
trembles  as  the  thought,  provided  he  is  a  new  con- 
vert, and  one  unacquainted  with  the  homoeopathic 
history  of  this  disease.  I  endeavor  to  remove  his 
solicitude,  by  assuring  him  that  there  is  no  method 
of  treating  Cholera  which  can  be  compared  with  Hah- 
nemann's.  Has  it  ever  been  tried  ?  This  question  is 
a  very  reasonable  one.  Thousands  of  Americans  will 
ask  it,  at  a  time  when  the  Cholera  is  approaching 
them,  in  a  form  as  virulent  as  was  ever  known  in  Eu- 
rope or  America,  if  we  can  judge  from  the  loss  of  one 
half  the  patients,  even  in  private  practice,  by  the 
European  and  American  allopathists. 

*  Lectures  on  the  Principles  and  Practise  of  Physic  ;  delivered 
at  King's  College,  London,  by  Thomas  Watson,  M.  D.  p.  828. 


OF    TREATMENT.  69 


I  will  let  statistics  answer  this  question  and  show 
the  relative  results.  Whence  the  horror  which  the 
name  of  this  disease  awakens?  It  comes  from  the 
deplorable  failure  of  allopathic  treatment. 

Let  no  one  trust  his  life  to  any  vaunted  method  of 
cure,  which  has  been  tried  only  by  a  few  scores  of 
patients,  and  by  one  or  two  physicians.  The  homoeo- 
pathic method  has  has  been  tried  on  many  thousands 
of  cholera  patients,  and  with  similar  success  in  dif- 
ferent countries. 

As  ratios  obtained  from  large  numbers  are  more 
reliable  for  showing  the  true  average,  and  as  the  epi- 
demic of  1831—1832  and  that  of  1849  are  those  in 
which  the  greater  number  of  cases  have  occurred,  and 
in  relation  to  which  more  facts  can  be  presented,  I 
shall  confine  myself  chiefly  to  them. 

Some  our  allopathic  brethren,  as  if  conscious  of 
the  weakness  of  their  system  on  the  broad  field  of 
extensive  statistics,  are  at  present  restricting  them- 
selves to  a  guerilla  warfare.  When  a  single  death 
occurs  among  the  patients  of  a  homoeopathic  physi- 
cian, it  is  noised  abroad  as  something  remarkable. 
But  if  any  one  is  desirous  of  knowing  the  true  rela- 
tive value  of  the  two  systems,  he  must  examine  the 
subject  on  a  broader  scale.  He  must  consider  the 
number  which  homoeopathy  cures,  in  his  own  city  or 
neighborhood,  and  throughout  the  world,  and  the  ave- 
rage relative  results  of  the  two  methods  of  treatment. 


70  HISTORY 

, 

THE  CHOLERA  EPIDEMIC  OF  1831—1832. 

In  1832  there  were  in  this  city  including  Bellevue 
5232  cases,  of  which  2031  died ;  i.  e.  nearly  one  out 
of  every  2£  or  2J,  or  in  round  numbers,  nearly  2  out 
of  5.  Of  persons  treated  at  their  homes,  there  were 
2859  cases,  of  whom  937  died  ;  i.  e.  about  one  in  every 
3  persons  attacked.  In  the  hospitals,  including  Belle- 
vue, there  were  2373  cases,  and  1094  deaths  ;  i.  e. 
nearly  one  half  died.  Such  were  the  best  results 
that  could  be  obtained  here  by  allopathic  skill. 

In  Europe,  in  1831 — 1832,  this  disease,  under  allo- 
pathic treatment,  was  still  more  fatal.  In  the  allo- 
pathic hospitals  of  Italy  and -France,  in  21  of  which 
I  have  seen  the  ratio  of  deaths  stated,  the  average  of 
the  ratios  gives  63  deaths  out  of  every  100  patients. 

The  only  treatment  which  proved  itself  worthy  of 
any  confidence,  was  the  homoeopathic.  It  is  not  de- 
nied by  allopathists  themselves,  that  it  was  the  great 
success  that  attended  the  homoeopathic  treatment  of 
Cholera  in  Europe,  that  gave  this  system  the  most 
powerful  impulse  that  it  has  ever  received.  Dr.  Bal- 
four  of  Edinburgh,  who  is  opposed  to  the  system, 
writes  to  Dr.  Forbes  from  Vienna  in  1836,  in  the  fol- 
lowing words  :  "  During  the  first  appearance  of  Cho- 
lera here,  the  practice  of  homoeopathy  was  first  intro- 
duced ;  and  Cholera,  when  it  came  again,  renewed  the 
favorable  impulse  previously  given,  as  it  was  through 
Dr.  Fleischmann's  successful  treatment  of  this  dis- 
ease, that  the  restrictive  laws  were  removed,  and  ho- 


OF    TREATMENT.  71 

raoeopathists  obtained  leave  to  practise  and  dispense 
medicines  in  Austria.  Since  that  time  their  number 
has  increased  more  than  threefold  ia  Vienna  and  its 
provinces."  He  also  says :  "  No  young  physician 
settling  in  Austria — excluding  government  officers — 
can  hope  to  make  his  bread,  unless  at  least  prepared 
to  treat  homoeopathically.  if  requested." 

Let  us  compare  the  results  of  the  two  systems  in 
the  same  city.  In  Vienna,  there  were  4500  patients 
treated  allopathically  ;  of  whom  1360  died.  There 
were  581  treated  homceopathically  ;  of  whom  only  49 
died.  This  give  31  per  cent,  of  deaths  under  the 
former,  and  only  8  per  cent,  under  the  latter. 

Dr.  Quin  of  London  has  given  a  table  of  the  results 
of  the  treatment  of  ten  different  homoeopathic  physi- 
cians. The  worst  result  under  any  of  these  physi- 
cians was,  the  death  of  only  one-fifth  of  his  patients, 
whilst  four-fifths  were  saved.  The  best  result  obtained 
by  any  one  of  these  physicians  was  the  saving  of  40 
out  of  every  41,  or  losing  3  out  of  125,  this  being  the 
number  of  cases  which  he  treated.  This  physician 
was  Dr.  Weith  of  Vienna.  These  cures  were  made 
at  a  time  when  this  pestilence  was  prevailing  in  that 
city  in  its  greatest  intensity,  and  baffling  all  the  skill 
of  allopathic  physicians. 

The  statements  of  this  venerable  man  can  be  relied 
on.  He  is  above  suspicion.  He  had  no  party  pre- 
judices to  mislead  him  ;  no  professional  interests  to 
advance.  Though  he  had  taken  the  degree  of  Doctor 
of  medicine,  his  profession  was  that  of  a  minister 


72  HISTORY 

of  religion.  But  when  he  beheld  his  fellow-citizens 
doomed  to  destruction,  his  feelings  as  a  man,  and  his 
principles  as  a  Christian,  impelled  him  to  stretch  forth 
his  arm  for  their  relief.  He  had  just  become  con- 
vinced of  the  truth  of  the  homoeopathic  doctrine,  and 
of  its  practical  importance.  It  was  distressing  to 
him,  to  be  continually  called  to  the  death-beds  of 
persons  who  might  have  been  saved  by  homoeopathy, 
but  were  perishing  in  spite  of  allopathy.  His  spirit 
was  stirred  within  him,  and  he  resolved  to  suspend  in 
part  and  for  a  time  his  functions  as  the  spiritual 
guide  of  his  people,  and  devote  himself  to  their  tem- 
poral salvation.  He  acted  as  a  true  disciple  of  Him, 
who  delighted  in  saving  not  only  the  souls  but  the 
lives  of  men. 

The  efforts  of  Dr.  Weith  were  crowned  with  a  suc- 
cess fully  justifying  the  expectations  which  he  had 
been  led  to  entertain  by  the  success  of  other  homoeo- 
pathic physicians  in  this  same  epidemic. 

The  remedies  which  he  employed,  were  Phos- 
phoric-acid, Veratrum,  Cuprum,  Tincture  of  Cam- 
phor, and  under  some  circumstances,  lavements  of 
ice-water. 

Of  the  1093  patients,  treated  by  the  ten  homoeo- 
pathic physicians,  998  were  saved,  and  only  95  lost. 
Thus  the  average  proportion  of  deaths  was  only  one 
to  11£,  or  2  out  of  23  patients,  whilst  21  out  of  23 
patients  were  saved.  The  results  above  stated  were 
chiefly  obtained  at  Vienna,  in  Moravia,  Bohemia  and 
Hungary,  during  the  epidemic  of  1831  and  1832. 


OF    TREATMENT. 


73 


Dr.  Rath,  who  had  been  sent,  in  April,  1832,  by  order 
of  the  king  of  Bavaria,  to  collect  authentic  informa- 
tion respecting  the  results  of  the  homoeopathic  treat- 
ment of  the  Cholera,  reported  officially  the  several 
results  of  the  treatment  of  14  homoeopathic  phy- 
sicians at  Prague,  in  Moravia,  in  Hungary  and  at 
Vienna.  The  total  number  of  cases  which  he  reported 
was  1269  ;  cures  1184,  deaths  85. 

In  Russia  and  Austria,  and  at  Berlin  and  Paris, 
there  were  3017  cases  treated  homoeopathically  ;  of 
which  2753  were  cured,  and  only  264  died  ;  i.  e.  only 
about  one  in  llj  died.  On  an  average  more  than  10 
out  of  11  were  cured. 

Hon.  Alexis  Eustaphieve,  the  Russian  Consul 
General,  has  given  the  results  obtained  by  homoeo- 
pathic treatment  in  various  parts  of  the  Russian  Em- 
pire in  1830  and  1831.  Of  70  patients  treated  in 
two  places,  all  were  cured.  The  total  result  was, 
that  of  1270  patients,  1162  were  saved,  and  only  108 
lost ;  showing  an  average  proportion  of  one  death  in 
11-J.  This  agrees  remarkably  with  the  success  ob- 
tained in  other  countries. 

These  facts  are  derived  from  the  reports  of  Ad- 
iniral  Mordvinow,  then  president  of  the  Imperial 
Council,  who  affirms,  that  "  Not  a  single  death  has 
occurred  where  Homoeopathic  treatment  was  resorted 
to  in  the  incipient  symptoms  of  the  Cholera ;"  and 
that  "it  was  remarked,  that  all  the  patients  cured  by 
Homoeopathia,  regained,  in  a  very  short  time,  their 
former  health  and  strength ;  while  those  who  sur- 


74  HISTORY 

vived  other  treatments,  were  left  in  a  state  of  weak- 
ness which  lasted  several  months,  and  but  too  often 
terminated  in  another  disease  which  proved  fatal." 

The  following  is  an  extract  from  a  letter  which 
Admiral  Mordvinow  received  from  his  daughter, 
Madame  Lvoff,  of  the  government  of  Saratow.  It  is 
dated  August  6th,  1831. 

"  The  dreadful  Cholera  broke  out  last  month  in 
our  own  village  and  its  vicinity  with  the  greatest 
fury.  My  husband  was  the  first  person  attacked ; 
but  thanks  to  Homceopathia,  was  cured  in  a  few  days. 
From  a  desire  to  relieve  the  sufferings  of  humanity, 
he  visited  all  the  places  in  the  neighborhood,  where- 
ever  the  disease  raged  the  most ;  administered  the 
remedies ;  instructed  the  priests  and  the  elders  in 
the  use  of  them  ;  and  was  whole  weeks  thus  employ- 
ed, while  I  remained  at  home  occupied  with  the  pre- 
paration of  Homoeopathic  powders.  Four  hundred 
Cholera  patients,  saved  and  restored  to  perfect  health, 
was  the  gratifying  reward  of  his  zeal,  and  the  trium- 
phant result  of  Homoeopathic  doses  liberally  distri- 
buted to  all  who  applied  for  them.  We  are  all  now 
so  well  convinced  of  the  miraculous  power  of  this 
system,  that  we  cannot  sufficiently  deplore  the  igno- 
rance that  cannot,  and  still  more  the  obstinate  pre- 
judice that  will  not  invoke  its  aid,  and  thereby  res- 
cue relatives  and  friends  from  certain  death.  The 
Asiatic  Cholera,  preceded  by  terror,  ushered  in  by 
danger,  and  followed  by  desolation,  comes  now,  re- 
mains, and  departs  a  harmless  thing.  Its  cure  is 


OF    TREATMENT.  75 


in  reality  easier  than  that  of  a  fever.  Multiplied  ex- 
periments, and  consequent  confidence  in  Homoeo- 
pathic treatment,  have  divested  it  of  all  its  appalling 
attributes,  by  subjugating  it  entirely  to  the  skill  of 
man.  We  had  fifty  patients  in  our  own  village, 
and  not  one  of  them  died.  On  the  estate  of  my 
sister-in  law,  there  were  likewise  a  good  many  cases, 
but  no  deaths.  There  is  also  an  abundance  of  reason 
to  believe,  that  the  fatal  termination  of  the  disease, 
wherever  it  occurred,  was  occasioned  altogether  by 
neglect,  want  of  necessary  precaution,  or  deviation 
from  the  rules  of  regimen  prescribed  by  Homceo- 
pathia.  All  the  sick  who  took  medicine  in  strict 
conformity  to  the  rules,  were  saved,  although  some 
of  them  were  already  in  the  state  of  collapse,  which 
apparently  precluded  all  hope.  In  this  last  stage 
there  were  not  a  few  with  their  teeth  clenched  so  fast 
that  it  was  necessary  to  force  them  open  for  the  pur- 
pose of  introducing  the  medicine  ;  and  yet,  on  the 
very  day  following,  they  were  relieved  and  convales- 
cent !  My  good  husband,  from  the  constant  inter- 
course with  the  sick,  took  the  infection  several 
times,  but  in  every  instance  was  restored  by  a  few 
Homo3opathic  globules.  In  short,  we  consider  our- 
selves perfectly  safe  from  this  dreaded  scourge,  what- 
ever may  be  its  potency,and  virulence.  The  repeated 
numerous  trials  have  more  than  satisfied  us,  that  in 
the  presence  of  Homoeopathia,  with  its  five  remedies 
only,  the  Asiatic  Cholera  is  not  a  mortal  disease, 


76  HISTORY 

and  still  less  so  when  encountered  at  it  commence- 
ment."* 

To  the  statistics  above  given,  in  relation  to  the 
first  invasion  of  this  disease,  I  need  not  add  a  word 
of  comment,  to  show  the  immense  superiority  of  the 
Homoeopathic  treatment.  Such  a  uniformity  in  the 
results  in  so  many  places,  and  with  such  a  number 
of  patients,  must  speak  convincingly  to  every  intelli- 
gent and  unprejudiced  mind. 


EPIDEMIC    OF    1848—1849. 

The  Cholera  which  prevailed  in  England  in  1848- 
1849,  and  in  New- York  in  1849,  was  equally  severe 
with  that  of  1831-32.  As  the  amount  of  homoeo- 
pathic as  compared  with  allopathic  practice,  in  Great 
Britain  and  the  United  States,  even  during  this  last 
epidemic,  was  small,  the  character  of  the  average  re- 
sults depended  mainly  upon  that  of  the  old  system, 
as  it  did  in  the  former  epidemic  invasions  of  the  same 
malady. 

Let  us  look  at  some  of  these  results. 

In  an  article,  written  in  Liverpool,  dated  Feb. 
24th,  1849,  and  relating  to  the  official  returns  made 
to  the  government,  respecting  the  number  of  cases, 
deaths  and  cures  in  Great  Britain,  from  the  com- 

*  "  Homoeopathia  Revealed,"  by  the  Hon.  Alexis  Eustaphieve. 
Mr.  Eustaphieve  has  a  copy  of  the  original  documents.  I  find  in 
the  "  Bibliotheque  Homoeopathique,"  the  same  extract,  with  a  very 
few  slight  verbal  discrepancies. 


OP    TREATMENT.  77 

mencement   of   the   epidemic,  it  is  stated,   that  the 
Cholera  returns  have  now  swelled  to  cases  12,485. 

Deaths 5,546 

Recoveries 3,788 

Remaining  under  treatment,  or  result  not 

stated        3,164 

Thus  more  than  one-third  had  died,  and  more  than 
two-thirds  had  not  yet  recovered. 

The  new  system  afforded  much  better  results 
than  this,  even  in  practice  among  the  poor.  For  ex- 
ample, at  the  Liverpool  Homoeopathic  Dispensary, 
there  were  between  July  25th,  and  Sept.  15th,  1849, 

Cases  of  Cholera 162 

Cures 119 

Deaths        43 

Per  centage  of  deaths  to  cases  .       26£ 

Let  us  next  look  at  one  or  two  results  on  the  At- 
lantic and  at  our  Quarantine. 

The  first  seven  cases  which  occurred  on  board  the 
packet  ship  New- York,  in  Dec.  1848,  died  under 
calomel  treatment.  The  ship  arrived  at  the  Quaran- 
tine at  Staten-Island,  near  New- York,  on  the  2d  of 
December,  and  landed  the  remaining  eleven  or 
twelve  patients,  who  had  survived  longer  under  a 
comparatively  inert  treatment.  From  the  statement 
of  the  captain,  and  the  daily  published  reports  of  the 
health-officer,  from  Dec.  5th  to  Jan.  4th — when  re- 
ports ceased  to  be  published — it  appears  that  in  the 
ship  before  her  arrival,  and  in  the  hospitals  at  the 
Quarantine  since,  there  had  occurred  .about  ninety- 


78  HISTORY 

six  cases  and  fifty-two  deaths,  from  Cholera.  The 
cases  at  the  Quarantine  were  under  the  care  of  the 
health-officer  himself,  a  skilful  allopathic  physician, 
who,  having  the  population  of  the  buildings  under 
his  supervision,  had  an  opportunity  of  instructing 
them  in  regard  to  premonitory  symptoms,  and  it  is 
to  be  presumed,  of  treating  them  in  an  early  stage. 
Yet  more  than  one-half  died,  under  calomel  and  other 
allopathic  treatment. 

There  is  no  instance  on  record,  of  such  mortality 
among  the  same  number  of  persons  under  homoeo- 
pathic treatment,  for  Cholera,  or  for  any  acute  dis- 
ease, whatever,  in  any  part  of  the  world. 

Again,  on  February  13th,  1849,  Cholera  broke  out 
on  board  the  ship  Liverpool,  bound  to  this  port. 
Symptoms — Cramps,  vomiting  and  purging.  At- 
tacks 50,  deaths  40. 

In  the  Cholera  of  1849,  the  Board  of  Health  of 
the  City  of  New-York,  required  of  the  physicians  of 
this  city,  a  daily  report  of  the  cases  and  deaths  oc- 
curring in  their  private  practice.  The  results  were 
published  daily  by  their  authority,  during  <the  greater 
part  of  the  epidemic.  But  as  the  total  results  are 
not  published  in  the  formal  and  final  report  of  the 
Board,  we  have  no  data  for  determining  the  average 
degree  of  success  which  attended  the  treatment  in 
private  practice. 

I  am,  however,  able  to  arrive  at  an  approximate 
estimate,  by  means  of  such  of  their  daily  reports  as 


OF    TREATMENT.  79 


I  was  able  to  find  in  the  daily  newspapers,  and  to 
copy  from  them,  in  the  months  of  June  and  July. 
My  record  extends  from  June  4th  to  July  31st  in- 
clusive, with  the  exception  of  six  days,  in  which  the 
numbers,  if  published,  were  not  found. 

As  thus  estimated,  the  following  are  the  results  of 
fifty-two  days'  private  practice,  chiefly  allopathic,  in 
this  city. 

Number  of  cases,  2,631. 

Number  of  deaths,  915. 

Per  centage  of  deaths,        34.78, 
i.  e.,  about  thirty-five  out  of  a  hundred  cases  died. 

Thus  according  to  these  reports,  about  one-third  of 
the  cases  in  private  practice  were  fatal.  The  ap- 
proximation of  this  result  to  those  generally  obtained 
in  private-  practice  at  other  times,  and  in  different 
parts  of  the  world,  affords  evidence  of  the  general 
truthfulness  of  the  reports  of  results,  to  the  same 
extent  that  cases  were  reported. 

That  approximation,  and  the  fact  that  the  deaths 
from  Cholera  in  the  list  kept  by  the  Board,  were 
fewer  than  those  in  the  report  of  the  City  Inspector, 
render  it  highly  probable,  that  those  physicians  who 
for  the  whole  or  a  portion  of  the  season,  neglected  to 
report  cases,  did  at  least  as  generally  neglect  to  re- 
port results ;  and  as  delinquency  in  the  performance 
of  these  duties  to  the  public  and  to  science,  cannot 
justify  a  presumption  of  peculiar  fidelity,  intelligence 
and  skill,  in  the  treatment  of  their  patients,  it  is  by 
no  means  probable  that  the  addition  of  their  reports, 


80  HISTORY 

if  complete,  would  have  given  to  tbe  general  report 
of  the  Board  of  Health,  a  more  favorable  complexion. 

The  number  of  cures  in  private  practice  was  not 
published. 

The  Board  of  Health  required  of  the  Resident 
Physician  a  report  on  the  history  of  the  epidemic  of 
1849  in  this  city.  In  this  official  report  it  is  stated, 
that  the  number  of  persons  admitted  into  the  five 
hospitals  was  1901. 

Deaths,  1,021. 

Cures,  880. 

Per  centage  of  cures,         46.29. 

Per  centage  of  deaths,       53.71. 
It  thus  appears,  that  more  than  half  of  those  ad- 
mitted into  the  allopathic  hospitals  died. 

The  city  authorities,  by  the  advice  of  allopathic 
physicians,  refused  the  application  of  the  friends  of 
Homoeopathy,  for  the  establishment  of  a  Cholera  hos- 
pital, in  which  those  who  chose  might  receive  homoeo- 
pathic treatment.  Consequently,  it  is  impossible  to 
give  any  relative  hospital  statistics  for  this  city. 
Whether  this  was  the  object  aimed  at  by  those  who 
instigated  the  refusal  of  this  reasonable  demand,  I 
will  not  presume  to  decide.*  Neither  will  I  afftrm 
that  the  dread  of  an  unfavorable  comparison,  had  an 
influence  in  the  suppression  of  the  publication  of  the 
reported  results  in  private  practice ;  although  no  one 

*  For  an  examination  of  the  reasons  urged  by  the  .Medical  Coun- 
sel, vide  appendix  to  Joslin's  "  Principles  of  Homoeopathy." 


OP    TREATMENT.  81 

has  denied  that  the  reports  of  physicians  were  as  re- 
liable in  1849  as  in  1832,  when  the  total  results  were 
considered  fit  for  publication.  But  the  young  giant 
was  then  an  infant,  and  by  no  means  so  formidable 
here,  as  to  deter  public  functionaries  from  the  dis- 
charge of  their  official  duties. 

In  order  to  obtain  as  authentic  and  official  statis- 
tics of  the  reformed  medical  treatment,  as  was  prac- 
ticable under  those  circumstances,  the  Homoeopathic 
Society  of  New- York,  early  in  the  epidemic,  publicly 
requested  the  homoeopathic  physicians  of  New- York 
and  Brooklyn,  to  report  to  them,  through  their  Sec- 
retary, such  cases  of  Cholera  as  they  had  reported  to 
the  Mayor,  Board  of  Health,  or  Resident  Physician, 
and  also  the  results  as  so  reported. 

This  plan  of  confining  the  Society  reports  to  cases 
and  deaths  reported  to  the  city  authorities,  who  were 
under  the  influence  of  a  rival  school,  jealous  and  vigi- 
lant, and  possessed,  by  means  of  these  reports,  of  the 
names  and  residences  of  the  patients,  within  twenty- 
four  hours  of  the  occurrence  of  the  case  or  death,  af- 
fords to  our  opponents  sufficient  security,  that  the  so- 
ciety reports  would  not  be  too  favorable  to  the  repu- 
tation of  our  system.  This  plan  also  gives  to  the  sta- 
tistics a  semi-official  character. 

Twenty  two  physicians,  (twenty-one  of  them  resid- 
ing in  New- York  proper,)  complied  with  the  request 
of  the  Society,  and  the  results  were  published  weekly, 
from  July  12th,  by  its  Secretary,  B.  F.  Bowers,  M.  D. 


82  HISTORY 

These  reports  embrace  the  cases  which  occurred  in 
their  practice,  from  the  commencement  to  the  termi- 
nation of  the  epidemic. 

To  those  who  are  acquainted  with  these  physicians, 
their  names  are  a  sufficient  guarantee  for  the  truth- 
fulness of  their  reports. 

I  give  them  as  they  stand  on  the  Secretary's  list, 
in  the  order  of  the  commencement  of  the  reports  to 
him.  They  are  :  Drs.  Bayard,  Stewart,  Joslin,  Ca- 
tor,  Bowers,  Bolles,  Ball,  "Taylor,  Wright,  Kinsley, 
Freeman,  Allen,  Baldwin,  Kirby,  Quin,  Moffat, 
Stearns,  Hallock,  Wilsey,  Denison,  Sherrill,  and  Mc- 
Vickar. 

The  following  table  exhibits  the  results  of  reports 
to  the  Society,  in  the  periods  there  stated,  said  re- 
ports referring  respectively  to  previous  ones  made  to 
the  municipal  authorities. 

Cases.  Deaths. 

In  one  week,  in  1849,  previously  to  July  12,    59  8 

"  "  from  July  12  to  19,  23  4 

"  "        «        "    19  to  26,  37  2 

"  "        "        "    26  to  Aug.  2,  43  9 

«  "        "     Aug.  2  to  9,  26  5 

"  "        "        "     9  to  16,  47  5 

"  "  V'        "     16  to  13,  42  6 

«  "        "        «      23  to  30,  13  2 

"  «        "        "     30  to  Sept.  6,  11  3 

"  "        "      Sept.  6  to  13,  7  2 

"  "        "        "      13  to  20,  3  1 


OF    TREATMENT. 


83 


Cases.  Deaths. 

In  one  week,  from  Sept.  20  to  27,  1         1 

Reports  postponed,*  37         5 

Case  reported  October  9th,  1         0 

"Total,  350  63 
Per  centage  of  deaths  15-f. 

It  appears  from  this,  that  the  mortality  in  private 
homoeopathic  practice  was  about 'fifteen  per  cent.; 
whilst  the  mortality  in  the  average  private  practice 
of  the  city,  for  the  time  embraced  in  our  records,  was 
about  thirty-five  per  cent. 

The  results  would  afford  a  comparison  still  more 
favorable  for  Homoeopathy,  if  we  excluded  from  the 
average  results  in  the  city,  that  portion  which  was 
reported  by  homoeopathic  physicians.  If  the  Board 
of  Health  had  reported  the  total  number  of  cases 
and  deaths  in  private  practice,  and  if  all  the  ho- 
moeopathic physicians  had  made  a  similar  report  in 
regard  to  their  practice,  we  should  have  had  the  re- 
quisite data  for  a  more  satisfactory  solution  of  the 
problem  of  the  relative  merits  of  the  two  systems. 
It  is  evident  from  the  advantage  which  the  general 
results  derived  from  the  more  favorable  homoeopathic 
results  incorporated  in  them,  that  had  it  been  in  our 
power  to  obtain  a  complete  report,  it  would  have  ex- 
hibited results  still  more  favorable  to  the  reputation 
of  the  new  method. 

But  were  it  possible  to  effect  this  separation,  and 

*  Reported  to  the  Board  ol  Health  some  time  previously  to  the 
20th  and  before  the  27th,  to  the  Secretary. 


84  INFECTION 


institute  a  comparison  between  the  reports  of  the 
new  and  those  of  the  old  school,  the  tables  would, 
even  then,  be  far  from  exhibiting  the  full  superiority 
of  the  actual  curative  results  of  the  new  method. 

Because — Firtt ;  the  want  of  a  homoeopathic  hos- 
pital threw  a  greater  number  of  desperate  cases  into 
the  private  practice  of  homoeopathic  physicians. 
Secondly ;  a  greater  number  of  desperate  cases  were 
transferred  from  other  physicians  to  them,  than  from 
them  to  others.  Thirdly ;  fewer  homoeopathic  chole- 
ra patients  died  from  other  diseases,  after  reaction. 
Fourthly;  many  of  them  were  cured  by  domestic 
camphor  treatment,  and  consequently  were  not  re- 
ported. 

I  will  consider  some  of  these  points  more  particu- 
larly. 

Those  who  have  an  opportunity  of  practising  ex- 
tensively during  the  whole  of  a  severe  cholera  epi- 
demic, will  see  so  many  cases  among  the  moral,  sober, 
intelligent  and  wealthy,  as  to  cease  to  consider  the 
disease  disgraceful  or  ungenteel — if  he  had  previous- 
ly indulged  such  a  prejudice.  There  is  much  less 
difference  between  the  rich  and  the  poor,  in  their  lia- 
bility to  an  attack  of  this  disease,  than  in  their  dan- 
ger of  dying  by  it.  But  fatal  cases  do  occur  in  a 
much  greater  proportion  among  the  latter. 

The  poor  of  our  city  having  been,  by  the  municipal 
government,  denied  the  advantage  of  a  homoeopathic 
hospital,  many  of  them,  who  preferred  the  treatment 
of  our  physicians,  had  to  be  attended  in  such  a  state 


OF    TREATMENT.  85 

of  want,  and  in  localities  so  crowded  and  impure,  that 
they  would  have  been  removed  to  a  hospital,  had  one 
existed  for  our  school.  Our  professional  brethren  of 
the  other  school  were,  in  private  practice,  often  re- 
lieved from  such  unpromising  cases.  I  am  of  opinion, 
that  nearly  all  the  fatal  cholera  cases  which  it  became 
the  duty  of  the  homoeopathic  physicians  of  this  city 
to  report,  occurred  either  among  the  poor,  or  else 
among  comparative  strangers  to  the  physician,  and 
even  to  the  practice.  The  latter  were  persons  who 
applied  to  us  for  aid,  after  having  exhausted  their 
own  resources,  or  those  of  their  allopathic  physician. 
In  my  own  practice,  no  family  which  had  employed 
me  previously  to  the  epidemic,  or  even  previously  to 
the  occurrence  of  the  case,  lost  any  of  its  members 
by  cholera.  Yet  fifty  cases  occurred  among  these  my 
own  proper  families,  and  were  all  cured. 

Some  of  our  cases  came  under  our  care  and  were 
reported  by  us,  after  their  condition  had  become  des- 
perate under  allopathic  practice ;  whilst  comparative- 
ly few,  and  I  have  not  heard  that  any,  of  our  cases 
were  transferred  to  the  old  school  under  similar  cir- 
cumstances. 

A  homoeopathic  cure  is  a  cure  in  reality ;  an  allo- 
pathic cure  is  often  merely  a  transfer  of  disease  to  a 
different  organ,  or  an  exchange  of  one  morbid  action 
for  another.  The  apparent  cure  of  cholera  by  large 
doses,  gave  rise  in  numerous  instances,  to  local  con- 
gestions of  vital  organs,  typhoid  fevers,  &c.  There 
is  little  doubt  that  in  private  practice,  the  deaths  in 


86  HISTORY 

these  cases  were  in  many  instances,  reported  under 
the  name  applicabll  to  the  form  which  the  disease 
last  assumed,  especially  where  the  death  occurred  a 
long  time  after  reaction  had  been  established. 

Now  there  is  little  chance  for  homcsopathy  to  im- 
prove its  cholera"  statistics  by  such  occurrences.  For 
these  new  forms  of  disease  are  extremely  rare  after 
homoeopathic  treatment.  The  cholera,  once  apparent- 
ly cured  by  small  doses,  is  really  cured. 

The  Board  of  Health  required  no  reports  of  cures ; 
but  I  rendered  them,  in  order  that  they  might  have 
data  for  testing  the  reality  of  the  cures,  and  verify- 
ing the  totality  of  my  reports.  In  a  report  made  to 
the  President  of  the  Board  on  the  7th  of  Septem- 
ber, 1849,  after  giving  the  names  of  eight  persons  re- 
cently cured  of  cholera,  (there  were  no  new  cases 
nor  deaths  to  report)  I  added  the  following  remarks : 
Of  every  case  of  cholera  reported  by  me,  I  have  re- 
ported the  result.  You  will  find,  that  the  numbers 
of  patients  which  I  have  reported  as  cured  of  cholera, 
and  died  of  cholera,  will,  when  added  together,  equal 
the  number  which  I  have  reported  as  attacked  with 
cholera. 

Finally,  great  numbers  who  were  attacked  with 
Cholera,  were  cured  immediately  by  their  domestic 
attendants,  with  that  use  of  Camphor  which  we  had 
advised.  In  some  of  these  instances,  the  physician 
was  not  called ;  in  others,  on  arriving  he  found  the 
patient  so  far  recovered,  that  he  could  not  report  it 
as  a  case  of  Cholera  then  under  his  care. 


OF    TREATMENT.  87 

If  the  influence  of  all  these  facts  were  duly  esti- 
mated in  the  statistics.it  would  be  found,  that  Homoeo- 
pathy had  not  lost  one-fourth  as  large  a  proportion 
of  its  cases  as  allopathy,  and  had  cured  nearly  as 
great  a  proportion  in  this  as  in  former  epidemics. 

As  evidence  of  the  extent  of  the  domestic  Camphor 
treatment  in  this  city,  so  far  as  the  influence  of  nearly 
all  the  principal  homoeopathic  physicians  could  secure 
its  adoption,  and  as  affording  also  a  model  for  circu- 
lars to  the  public  in  any  place  where  Cholera  pre- 
vails, I  insert  the  following  card,  which  those  phy- 
sicians published,  and  distributed  as  widely  as  pos- 
sible among  the  families  which  they  attended. 

ADVICE   TO   THE  PUBLIC   IN   RELATION  TO 
CHOLERA. 

NEW- YORK,  June  2d,  1849. 

The  undersigned,  Physicians  of  the  city  of  New- 
York,  believing  that  d*uring  the  prevalence  of  Cho- 
lera, many  lives  are  in  danger  of  being  sacrificed  to 
improper  modes  of  treatment,  recommended  in  the 
newspapers,  consider  it  their  duty  to  warn  the  public 
of  the  danger  of  using  the  drugs  generally  recom- 
mended, and  large  doses  of  medicine  of  any  kind. 
Since  homoeopathy  has  saved  91  out  of  100  in  thou- 
sands of  cases  of  Cholera,  we  feel  confident  that  it 
will  cure  almost  every  case,  provided  the  physician 
is  called  immediately  after  the  attack,  and  before 
any  other  treatment  has  been  resorted  to.  But  if 
any  other  medicine  beside  the  appropriate  homoeo- 
pathic remedies  are  employed,  or  if  several  hours 


88  HISTORY 

elapse,  before  the  proper  treatment  is  commenced, 
the  cure  will  in  many  cases  be  impracticable  by  any 
treatment. 

It  is  important  that  the  community  should  be 
especially  warned  against  the  use  of  Laudanum  and 
Opium  in  any  form,  as  well  as  calomel  and  all  the 
advertised  specifics. 

During  the  prevalence  of  Cholera,  every  person 
should  immediately  consult  his  physician  for  the 
slightest  diarrhoea,  (whether  with  or  without  pain,) 
avoiding  Laudanum,  and  also  cathartics  even  of  the 
mildest  kind.  If  medical  advice  cannot  be  obtained 
within  an  hour  or  two,  the  patient  may  take  spirits 
of  Camphor  a  few  times,  in  a  dose  of  one  drop. 

Every  person  attacked  with  such  diarrhosa,  vomit- 
ing, cramps,  colic  or  other  symptoms,  as  give  an  ap- 
prehension that  actual  Cholera  has  commenced,  should 
take  one  drop  of  spirits  of  Camphor  in  sugared  water, 
every  five  minutes,  and  nothing  else,  until  relief  is 
obtained,  or  the  physician  arrives. 

Twelve  drops  of  the  Camphor,  dropped  in  a  table- 
spoonful  of  white  sugar,  may  be  dissolved  in  twelve 
table-spoonfuls  of  cold  water,  and  one  table-spoonful 
of  this  solution  be  given  every  five  minutes.  This, 
in  most  cases,  will  make  an  excellent  foundation  for 
the  complete  cure  by  the  physician ;  but  he  should 
be  immediately  called,  whatever  may  be  the  apparent 
amendment. 

Spirits  of  Camphor  should  not  be  used  in  large 
doses  as  a  curative,  nor  by  persons  in  health,  in  any 


OF    TREATMENT.  89 

dose,  with  the  expectation  of  preventing  the  disease  ; 
but  we  believe  that  appropriate  homoeopathic  medi- 
cines are  efficacious  as  preventives. 

We  have  not  here  given  any  advice  for  the  use  of 
other  medicines  beside  Camphor,  believing  it  im- 
practicable to  point  out  the  indications  for  each  in  a 
few  words.  Those  who  cannot  consult  a  physician 
will  find  full  directions  in  works  written  expressly  on 
this  subject.* 

J.  H.  ALLEN,  M.D.         B.  F.  JOSLIN,  M.D. 

A.  S.  BALL,  M.D.  HUDSON  KINSLEY,  M.D. 
S.  B.  BARLOW,  M.D.        S.  R.  KIRBY,  M.D. 
EDWARD  BAYARD,  M.D.  M.  E.  LAZARUS,  M.D. 

J.  BEAKLEY,  M.D.  JOHN  AUG.  McVicKAR, M.D. 

CLARE  W.BEAMKS,M.D.  JAMES  M.  QUIN,  M.D. 
R.  M.  BOLLES,  M.D.        H.  SHERRILL,  M.D. 

B.  F.  BOWERS,  M.D.        DANL.  E.  STEARNS,  M.D. 
J.  BOWERS,  M.D.  W.  STEWART,  M.D. 

H.  HULL  CATOR,  M.D.     J.  TAYLOR,  M.D. 
WM.  CHANNING,  M.D.     F.  L.  WILSEY,  M.D. 
ALFRED  FREEMAN, M.D.  CLARK  WRIGHT,  M.D. 
CHAS.  J.  HEMPEL,  M.D. 

The  cases  of  diarrhoea  and  other  choleroid  affec- 
tions, treated  by  the  homoeopathic  physicians  of 
New- York  during  this  epidemic,  were  probably  eight 
or  ten  times  as  numerous  as  those  which  they  re- 


*  The  first  edition  of  this  book  had  been  published  in  March. 
The  advice  in  the  above  circular  is,  so  far  as  it  extends,  in  accord- 
ance with  the  book,  and  for  this  reason  is,  to  that  extent,  a  recom- 
mendation of  it  by  the  physicians  signing  the  circular. 


90  I1ISTOKY 

garded  and  reported  as  Cholera.*  As  those  diar- 
rhoeas and  other  choleroid  cases  were  all  cured,  the 
addition  of  their  number  to  that  of  the  Cholera 
cases,  would  reduce  the  per-centage  of  deaths  to  less 
than  two.  It  would  not  however  be  fair  to  take  ad- 
vantage of  such  a  combination,  in  estimating  the 
relative  success  of  the  two  systems.  Candor  re- 
quires the  acknowledgment,  that  most  allopathic  phy- 
sicians in  our  city  probably  agreed  with  us  in  not 
reporting  cases  of  mere  cholerine  or  other  choleroid 
affections.  Both  schools  reported  only  cases  of  de- 
veloped Cholera. 

In  Cincinnati,  Ohio,  during  the  epidemic  of  1849, 
the  extent  and  success  of  the  homoeopathic  treat- 
ment were  remarkable. 

Drs.  Pulte  and  Ehrmann  of  that  City  used  the 
one-drop  doses  of  Camphor  with  almost  universal 
success,  early  in  the  disease.  In  more  advanced 
cases,  they  employed  homoeopathic  attenuations,  of 
Arsenicum,  Carb.-v.,  Cuprum,  Secale,  Vcratrum,  &c. 
They  had  cases  of  Cholera  .  1.116 

Deaths,  only 35 

Per-centage  of  deaths     ...  3| 

This  brilliant  success,  the  saving  of  about  97  cases 
in  a  hundred,  seems  to  have  been  attained  in 'the 
use  of  Camphor  which  would  be  considered  exces- 
sively small  by  the  soi-disant  regular  physicians, 
and  by  other  medicines  in  a  state  so  dilute,  that 
the  doses  would  be  regarded  as  inefficient  or  unre- 


*  If  I  may  judge  from  Dr.  Kinsley's  records  and  my  own. 


OF    TREATMENT.  91 


liable  by  such  of  our  school  as  confine  their  prac- 
tice chiefly  to  mother  tinctures  extemporaneously 
diluted,  and  to  the  first  attenuation.  Dr.  Pulte, 
in  those  instances  in  which,  in  his  "  Domestic  Phy- 
sician" since  published,  he  states  the  particular  at- 
tenuations to  be  given  in  Cholera,  generally  recom- 
mends high  dilutions  ;  in  only  one  instance  (that 
of  Prussic-acid),  the  second,  in  one  (that  of  Veratrum), 
the  12th  ;  whilst  of  Arsenicum,  Carbo-veg.,  Cuprum 
and  Secale,  he  recommends  no  other  than  the  30th 
dilution.  Such  it  may  be  presumed  was  his  prac- 
tice ;  and  I  was  informed  at  that  time,  that  Drs.  • 
Pulte  and  Ehrmann  used  high  dilutions  in  that 
epidemic. 

In  addition  to  these  cases  of  Cholera,  they  treated 
1.350  cases  of  cholerine  or  diarrhoea,  all  of  which, 
as  well  as  the  dysenteries,  were  cured.  The  success 
of  the  homoeopathic  treatment  in  dysentery,  provided 
the  medicines  are  sufficiently  attenuated,  is  every 
where  remarkable. 

In  the  large  number  of  cholera  cases,  as  compared 
with  diarrhoeas,  the  epidemic  in  Cincinnati  might 
appear,  from  the  above  account  to  have  been  remark- 
ably different  fronAhat  in  New-York,  the  same  year; 
also  from  that  in  Liverpool,  where,  according  to  Dr. 
Drysdale's  article  in  the  British  Journal,  the  number 
of  cases  of  cholerine,  diarrhoea  and  dysentery,  treated 
at  the  Liverpool  Homoeopathic  Dispensary  that  year, 
amounted  to  upwards  of  1,000  whilst  the  number  of 


92  HISTORY 

cases  of  Cholera,  treated  by  the  physicians  of  the 
dispensary  was  175. 

•  Some  cholera  statistics  are  given  by  Dr.  Russell 
of  Edinburgh  and  Dr.  Drysdale  of  Liverpool,  in  two 
elaborate  and  ably-written  articles  in  the  British 
Journal  of  Homoeopathy,  Vol.  7th  and  8th,  from  the 
last  of  which  a  part  of  the*  preceding  information 
has  been  obtained.  They  describe  many  cases.  The 
dilutions  ranged  from  the  first  to  the  sixth. 

At  the  Liverpool  Homoeopathic  Dispensary,  in 
1849,  among  patients  in  indigent  circumstances,  and 
consequently,  when  attacked,  more  liable  than  others 
to  die  of  Cholera,  the  per-centage  of  deaths  was 

OC    7  I 

zo-nnr- 

In  the  same  city  for  three  months,  in  the  practice 
of  physicians  mainly  allopathic,  the  per-centage  was 
46. 

At  the  Edinburgh  Homoeopathic  Dispensary,  there 
•were,  from  the  8th  of  October  to  the  6th  of  December, 
1848: 

Cases  of  Cholera 173 

Recoveries 124 

Deaths 48 

Under  treatment  at  the  tkne  of 

the  report 1 

Per-centage  of  deaths  ....       -7ff. 

This    being,  like    that    reported    at   Liverpool, 

dispensary  practice,    and    consequently   among   the 

poor,  the  results  should  be  compared  with  something 

intermediate  between  allopathic  hospital  and  private 


OF    TREATMENT.  93 


practice,  to  show  the  relative  success  of  the  two 
systems. 

In  the  cases  included  in  the  statistics  given  in  this 
book,  the  average  New- York  doses,  were  smaller  than 
those  of  Edinburgh  and  Liverpool ;  and  larger  than 
those  of  Cincinnati  in  the  same  year,  and  those  of 
continental  Europe  in  the  first  epidemic.  The  re- 
sults afford  some  evidence  in  favor  of  the  higher  di- 
lutions, in  all  these  groups  of  cases  as  compared  with 
each  other.  The  same  conclusion  in  favor  of  the 
higher  potencies,  may  be  drawn  from  the  relative 
success  of  Drs.  Meyerhoefer  and  Fleischmann,  at  the 
Hospital  of  the  Sisters  of  Charity  in  Vienna,  during 
the  first  two  epidemics. 

As  there  may  be  other  circumstances  beside  the 
treatment,  that  modify  the  results,  we  should  attach 
no  great  importance  to  the  evidence  afforded  by  two 
such  classes  of  facts,  as  compared  merely  with  each 
other ;  but  with  an  increase  in  the  number  of  cor- 
roborative classes,  the  probability  increases  in  a  ratio 
vastly  higher  than  that  in  which  the  number  in- 
creases. The  above  coincidences  appear  to  me  suffi- 
ciently numerous  to  merit  serious  consideration. 

From  considerations  of  delicacy,  I  have  refrained 
from  giving  the  average  results  in  the  practice  of 
individual  physicians,  either  as  bearing  upon  the  re- 
lative success  of  the  two  schools,  or  that  of  the  diffe- 
rent shades  of  our  own. 

Had  the  materials  been  accessible,  it  would  have 
been  gratifying  to  publish  a  more  comprehensive 


94  HISTORY 

statement  of  the  results  of  the  homoeopathic  and  allo- 
pathic methods  of  practice  in  the  epidemic  of  1849. 
Such  numerical  statements  as  I  have  met  witl^  have 
been  introduced  into  this  book,  provided  they  were 
well  authenticated,  and  referred  to  numbers  suffi- 
ciently large  to  afford  a  probable  approximation  to 
the  general  average  of  the  results  of  either  method 
in  any  considerable  population.  They  have  been 
impartially  selected  on  the  principles  above  stated, 
and  not  with  any  reference  to  their  comparative 
bearing  upon  the  reputation  of  our  system.  The  re- 
sults (so  far  as  known)  under  homoeopathic  treat- 
ment in  Edinburgh,  Liverpool,  New-York  and  Cin- 
cinnati, were : 

Cases  of  Cholera 1813 

Deaths  from  Cholera  ....  181 
Per- centage  of  deaths  .  .  .  9TW 

i.  e.  the  mortality  was  nearly  ten  per-cent. 

The  probability  that  this  is  a  near  approximation 
to  the  general  average  for  our  school,  is  increased  by 
combining  the  above  numbers  with  others  referring 
to  a  previous  epidemic  in  other  places.  Thus,  under 
the  homoeopathic  treatment,  in  Russia  and  Austria, 
and  at  Berlin  and  Paris,  in  1831  and  1832,  in  Edin- 
burgh in  1848,  and  in  Liverpool.  New- York  and  Cin- 
cinnati in  1849,  there  were,  so  far  as  the  statistics 
could  be  collected  : 

Cases  of  Cholera  ..'...  4,830 
Deaths  from  Cholera  .  .  .  445 
Per-centage  of  deaths  9i,  or  exactly 


OF 


TREATMENT.  95 


That  is,  on  an  average,  under  the  system  of  Hahne- 
mann  about  91  out  of  a  hundred  attacked  with  this 
terrible  malady  have  been  saved. 

Allopathy  loses  about  four  times  as  large  a  pro- 
portion of  its  Cholera  cases ;  or  three  times  as  many 
in  practice  exclusively  private. 

Avoiding  any  attempt  to  make  out  a  case  by  spe- 
cial pleading,  I  have  here  summed  up  the  numbers 
as  they  are  found  without  modification. 

This  is  a  subject  on  which  the  simple  expression 
of  the  naked  mathematical  truth,  may  to  many  seem 
like  satire  and  self-laudation.  Such  a  view  would 
do  injustice  to  the  spirit  in  which  these  estimates 
have  been  undertaken,  and  their  inevitable  conclusions 
exhibited.  Whilst  we  lament  the  impotence  of  our 
art  in  many  cases  of  complete  collapse,  and  an  ave- 
rage mortality  in  developed  cases  in  general,  exceeding 
that  in  many  other  maladies,  it  is  proper  to  search 
for  the  exact  truth  in  relation  to  the  absolute  and 
relative  success  of  the  two  methods,  and  to  state  it 
for  the  confirmation  and  consolation  of  new  proselytes, 
and  the  persuasion  of  sceptics  and  opponents. 

Grateful  to  the  Author  of  all  good  for  the  know- 
ledge of  this  beneficient  system,  we  are  desirous  that 
others  should  appreciate  and  enjoy  its  advantages ; 
but  we  claim  no  innate  superiority  for  ourselves,  nor 
any  perfection  for  the  details  of  our  practice.  The  law 
of  Hahnemann  is  an  immutable  verity  ;  but  we  hope 
for  ampler  materials,  as  the  media  of  its  application. 
We  desire  that  the  powerful  intellects  which  are  now 


yb  HISTORY 

wasted  in  the  toils  of  a  field  comparatively  barren, 
should  be  directed  to  a  science  whose  cultivation  is 
sure  to  be  rewarded  with  n^v  and  practical  truth. 
The  distinctive  appellations  for  the  two  principal 
sects,  now  existing  in  the  medical  world,  are  applied 
to  them  for  the  sake  of  precision,  not  the  one  as 
boastful,  the  other  contemptuous.  They  are  both 
equally  expressive  and  respectful ;  but  we  hope  for  a 
distant  future,  when  the  universal  adoption  of  our 
system  shall  render  such  distinctions  unnecessary 
and  obsolete,  and  the  terms  allopathist  and  homoeo- 
pathist  be  known  only  in  history. 

In  giving  the  statistics  which  I  have  been  able  to 
collect  for  the  epidemic  of  1849,  I  have  not  alluded 
to  informal  accounts,  unaccompanied  by  exact  nume- 
rical statements  ;  though  these  more  vague  accounts 
of  the  treatment  in  the  cities  of  Europe  and  America, 
are  every  where  favorable  to  our  system,  from  Peters- 
burgh  and  Riga  in  the  North-East,  to  St.  Louis  and 
New-Orleans  in  the  South-West. 

I  shall  conclude  this  chapter  with  an  item  of  recent 
news,  illustrating  the  ravages  of  the  pestilence  at  the 
commencement  of  the  present  year,  the  self-sacri- 
ficing zeal  with  which  a  Christian  minister  could 
peril  his  health,  liberty  and  life,  when  sustained  by 
confidence  in  homoeopathic  truth,  and  a  sense  of  duty 
to  suffering  humanity. 


OF    TREATMENT.  97 


CHOLERA     IN     1854. 

During  the  past  winter,  the  Cholera,  as  is  usual  at 
that  season,  has  been  almost  exclusively  confined  to 
warm  climates.  We  have  accounts  of  its  ravages  in 
some  of  the  West  India  islands,  and  in  some  portions 
of  Central  America,  but  not  many  facts  in  relation  to 
its  treatment  or  statistics. 

The  following  is  an  interesting  extract  from  a  let- 
ter from  Rev.  Frederick  Crowe,  a  Baptist  Mission 
ary  in  Balize,  Honduras,  dated  2d  February,  1854, 
directed  to  Mr.  C.  T.  Hurlbut,  a  homoeopathic  phar- 
maceutist of  New-York.  After  ordering  for  a  friend 
a  supply  of  medicines,  and  the  most  necessary  ho- 
moeopathic books,  he  adds  : 

)  "  Any  tracts  on  the  first  principles  of  homoeopathy, 
that  you  can  add,  would  be  of  use  here,  as  the 
system  has  been  hitherto  unknown,  save  by  vague 
report. 

"My  arrival  here  with  the  supply  I  had  of  you  was 
timely.  Three  weeks  ago  the  Cholera  broke  out; 
and  it  has  been  raging  ever  since,  so  that  ten  or 
twelve  have  died  daily,  in  a  population  of  8,000. 
One  day  twenty-six  died.  We  hear  reports  of  much 
greater  mortality  in  the  surrounding  country. 

"  I  felt  it  my  duty  to  put  by  every  other  occupation 
and  attend  exclusively  to  the  sick ;  using  the  homoeo- 
pathic treatment  of  course.  This  drew  down  the 
opposition  of  the  medical  men,  the  Board  of  Health 


98  HISTORY 

and  I  regret  to  add,  of  the  ministers  of  religion,  of 
all  the  other  denominations.  I  was  threatened  with  a 
trial  for  my  life  on  the  first  case  of  death  under  my 
treatment.  I  felt  it  my  duty  to  proceed,  and  bear 
any  penalty  that  might  follow ;  and  I  soon  found 
that  public  opinion  protected  me  from  any  overt  acts 
on  the  part  of  the  enemies  of  the  system. 

"I  printed  the  directions  of  which  I  enclose  you  a 
copy,  both  in  English  and  Spanish,  and  being  ably 
seconded  by  Mr.  Henderson,  and  more  or  less  assist- 
ed by  several  of  our  native  teachers,  the  homosopa- 
thic  treatment  soon  became  general,  and  the  usual 
practice  almost  exceptional. 

"  I  believe  that  hundreds  have  been  preserved  by 
the  means  we  used — as  the  Camphorated  Spirits  of 
Wine  may  now  be  found  in  almost  every  house  in  the 
settlement,  and  it  is  resorted  to  at  once  by  the  poor ( 
people  on  the  first  appearance  of  the  terrible  malady. 
Many  cases  I  have  superintended  myself,  laboring 
night  and  day,  as  far  as  my  strength  would  permit ; 
and  in  order  to  make  that  go  further,  I  hired  a 
horse,  and  looked  for  all  the  world  like  the  regular 
practitioners — which  I  fear  has  provoked  them  still 
more. 

"My  success  has  been  highly  encouraging.  Out 
of  scores  of  cases,  for  I  soon  lost  count,  only  five  or 
six  have  died  while  I  attended  them ;  and  several 
of  them  were  tampered  with  by  the  Allopathists  or 
by  the  misguided  zeal  of  friends,  either  previously 


OP    TREATMENT.  99 

to,  or  during  my  treatment,  and  others  were  far  gone 
before  I  was  called  in. 

"I  may  yet  be  called  to  suffer  for  what  I  have  done, 
as  I  am  not  licensed,  (to  kill  or  cure,)  but  I  am  pre- 
pared for  the  worst ;  and  am  satisfied  that  I  have 
only  done  my  duty.  The  poor  people  are  grateful, 
and  a  Homoeopathic  doctor  would  have  no  difficulty 
in  getting  into  good  general  practice  here,  on  the 
strength  of  the  present  excitement. 

"  In  one  of  the  hospitals  improvised  for  the  occasion, 
not  a  single  patient  recovered.  But  three  patients 
left  it  in  a  panic  before  they  were  either  killed  or 
cured.  It  now  goes  by  the  name  of  the  slaughter 
house.  The  method  pursued  by  our  opponents  is 
terrific. — Draughts  of  Cayenne  pepper,  or  pills  of  the 
same,  large  doses  of  ammonia,  confection  of  opium 
and  prepared  chalk,  with  rubbings  of  turpentine,  and 
both  frictions  with,  and  plentiful  draughts  of  raw 
brandy,  upon  the  Cayenne,  &c. — These  are  their 
principal  agents.  As  you  may  suppose,  few  could 
stand  such  treatment,  and  the  Cholera  too.  Either 
one  alone,  a  good,  strong  constitution  might  grapple 
with  and  recover. 

"I  intend  to  write  to  Dr.  Joslin,  whose  book  on 
Cholera  has  been  of  much  use  to  me — and  to  the 
journal  also — but  hitherto  I  have  had  no  time.  You 
are  at  liberty  to  publish  any  part  of  this." 


100  EARLY 

CHAPTER    IV. 

EARLY  TREATMENT, 

DOMESTIC    AND    PROFESSIONAL, 

INCLUDING  THAT  OF  THE  PREMONITORY  SYMPTOMS,  AND 
OF  THE  DISEASE  AT  ITS  ONSET,  WITH  DIRECTIONS  FOR 
THE  GENERAL  MANAGEMENT. 


DOMESTIC     AND    PROFESSIONAL     TREAT- 
MENT OF    PREMONITORY   SYMPTOMS, 
AND  THE    SLIGHTER  ATTACKS. 

During  the  prevalence  of  Cholera  in  any  locality. 
every  person  should  consult  his  physician  for  such 
slight  symptoms  as  often  precede  Cholera.  On  such 
application  to  the  physician,  if  a  homoeopathist,  the 
disease  may  almost  always  be  warded  off,  or,  if  com- 
mencing in  a  slight  form,  immediately  cured,  and  pre- 
vented from  advancing  into  the  form  of  Cholera  pro- 
per. The  most  usual  premonitory  symptom  is  a 
foecal  diarrhoea,  often  so  slight  that  it  would  excite  no 
apprehension  in  ordinary  times.  Or  the  evacuations 
may  be  rather  copious,  or  in  moderate  quantity  and 
milky,  no  other  symptoms  being  present.  In  any  of 
these  forms,  diarrhoaa  in  the  epidemic  is  called  Cho- 
lerine. It  will  be  again  referred  to  as  the  first  stage 
of  the  first  variety  of  Cholera  ;  yet  the  importance  of 
an  early  attention  to  it  is  so  great,  that  at  the  ex- 


TREATMENT.  101 


pense  of  some  repetition,  a  familiar  account  of  its 
symptoms  and  first  treatment  are  given  in  this  place, 
for  the  convenience  of  such  families  as  may  use  this 
book,  and  physicians  hitherto  unacquainted  with  this 
practice. 

Where  there  is  diarrhoea  without  any  special  indi- 
cation for  any  particular  remedy,  give  one  drop  of 
spirits  of  Camphor,  on  a  lump  of  sugar  or  in  sugared 
water.  Give  another  drop  after  one  hour, — or  ear- 
lier, if  the  diarrhoea  returns — and  let  it  be  followed 
by  three  doses  of  the  3d  attenuation  of  Camphor,  at 
intervals  of  an  hour,  or  after  each  evacuation,  if  it 
occurs  sooner  ;  after  this,  if  the  diarrhoea  continues, 
Phosphorus  ao  /  if  the  tongue  sticks  a  little  to  the 
finger  when  applied  to  it,  give  Phosphoric-acid ;  if 
it  has  a  yellowish  coM^nd  there  is  colic  or  dizziness, 
give  Veratrum  30.  Whichever  medicine  is  given, 
it  may  be  repeated  after  each  evacuation,  if  it  is 
large,  or  after  every  two,  if  they  are  small. 

For  other  symptoms  consult  the  succeeding  chap- 
ters, including  the  Repertories,  Chapters  X  and  XI.* 

The  Camphor  may  also  be  used  for  a  short  time, 
with  advantage  for  most  other  symptoms  ;  but  if  this 
is  domestic  treatment,  there  should  be  no  unneces- 
sary delay  in  consulting  a  Homoeopathic  physician  ; 

*  The  principal  divisions  of  the  Repertories,  are  in  the  order  in 
which  it  would  be  most  natural  to  examine  (from  above  downwards) 
those  different  parts  of  the  body  to  which  the  symptoms  belong  ; 
whilst  the  subordinate  arrangement,  that  of  the  different  parts  of 
each  section  of  the  repertory,  is  alphabetical. 


102  EAKLV 

as  the  disease  may  reach  a  dangerous  height  before 
the  appropriate  remedy  is  employed. 

In  giving  pellets  of  any  medicine,  in  the  dry  state, 
a  good  general  rule  is  :  Put  two  or  three  pellets  in  a 
small  powder  of  pure  sugar  or  sugar  of  milk,  fold  the 
paper,  then  mash  the  pellets,  then  open  the  paper, 
and  mix  them  by  moving  the  paper  without  touching 
the  powder.  Then  with  the  paper  bent  at  an  angle, 
place  its  edges  in  contact  with  the  upper  lip  or  teeth', 
let  the  powder  slide  on  the  tongue  without  touching 
it  with  the  paper.  The  patient  should  hold  his  head 
back,  his  mouth  open,  and  his  tongue  out,  and  allow 
the  powder  to  dissolve  on  the  tongue  before  swallow- 
ing it. 

Where  a  number  of  doses  of  any  one  medicine  are 
to  be  given  in  succession,  it  ^Inore  convenient  and 
equally  effectual  to  dissolve  five  or  six  pellets  in  a 
gill  of  water,  and  give  one,  two  or  three  teaspoon- 
fuls — according  to  the  patient's  age — at  a  dose.  This 
may  be  considered  as  applying  to  any  case,  in  this  or 
or  any  other  stage. 


DOMESTIC  AND  PROFESSIONAL  TREAT- 
MENT AT  THE  COMMENCEMENT  OF 
CHOLERA  IN  ALL  ITS  FORMS. 

When  there  is  a  decided  attack  of  Cholera,  we  re- 
sort for  the  first  hour,  or  a  longer  or  shorter  time 
according  to  circumstances,  to  a  treatment  for  which, 
as  well  as  for  all  the  most  successful  modes  of  pre- 


TREATMENT.  103 


venting  and  curing  this  disease,  the   world  is  indebt- 
ed to  Hahnemann. 

Whatever  may  be  the  form  of  the  attack,  give  one 
drop  of  the  tincture  of  Camphor,  dropped  on  a  lump 
of  sugar,  and  then  dissolved  in  a  tablespoonful  of 
cold  water.  Repeat  this  every  five  minutes,  until 
there  is  a  decided  mitigation  of  the  symptoms.  This 
will  usually  be  after  five  or  six  doses.  One  sign  of 
its  good  effect  is  perspiration.  In  proportion  as  the 
symptoms  yield,  let  the  doses  be  at  longer  intervals, 
as  an  hour,  two  hours,  twelve  and  even  twenty-four 
hours.  For  these  later  doses,  the  third  attenuation 
would  probably  be  preferable.  If  the  disease  is 
taken  in  time,  ten  or  twelve  doses  of  the  tincture  are 
ordinarily  sufficient.  If  the  stomach  will  not  retain 
the  Camphor,  even  in  ice-water,  then  give,  before  and 
after  it,  a  bit  of  ice  as  large  as  a  filbert ;  or  reduce 
the  dose  to  one-quarter  of  a  drop,  if  necessary.  In 
order  to  commence  immediately,  the  first  dose  may 
be  a  drop  on  a  lump  of  sugar ;  but  as  soon  as  there 
is  time,  dissolve  it  as  hereafter  directed. 

The  patient  should  continue  in  bed  and  be  covered, 
for  many  hours,  as  exertion  and  check  of  the  perspi- 
ration excited  by  the  Camphor,  would  both  at  first  tend 
to  prevent  improvement,  and  afterwards  to  occasion 
relapse,  even  after  the  cure  had  considerably  advanced. 

In  the  preparation  of  this  spirits  of  Camphor, 
Hahnemann  recommended  the  proportion  of  one  oz. 
of  solid  Camphor  (the  gum  as  it  is  called)  to  twelve 
of  alcohol.  Dr.  Quin  used  the  proportion  of  one  to 


104  EARLY 

« 

six.  The  usual  tincture  of  the  shops  is  suitable. 
The  method  which  is  most  convenient  and  useful, 
and  one  which  I  have  employed  in  many  cases  of 
severe  Cholera,  is  to  put  twelve  drops  of  campho- 
rated spirits  in  a  tablespoonful  of  sugar,  and  dis- 
solve it  in  twelve  tablespoonfuls  of  cold  water  in  a 
tumbler,  and  give  a  tablespoonful  of  this  mixture 
every  five  minutes  tift  relief  is  obtained.  Where 
there  is  great  difficulty  in  retaining  fluids  on  the 
stomach,  let  the  medicine  be  so  dissolved  that  a 
teaspoonful  shall  be  a  dose.  If  the  water  were  not 
rendered  viscid  by  sugar,  much  of  the  Camphor  would 
rise  to  the  surface,  and  if  the  spirits  were  dropped 
into  water  first,  the  Camphor  would  be  precipitated 
at  the  surface. 

Families  should  be  provided  with  the  Camphor, 
and  in  case  of  attack  administer  it  immediately  be- 
fore the  arrival  of  the  physician,  who  will  judge 
whether  it  is  to  be  continued.  In  some  cases  of 
severe  spasms,  it  might  perhaps  be  admissible  to 
give  the  Camphor  every  third  minute,  till  there  was 
some  mitigation.  But  the  advantages  of  the  Cam- 
phor treatment  cannot  be  secured  by  Allopathic 
doses,  whether  at  short  or  long  intervals.  In  the 
former  case,  the  disease  would  be  aggravated  ;  and 
in  the  latter  case,  the  medicinal  action  would  become 
exhausted :  in  both  cases,  the  stomach  would  be  ir- 
ritated. If  one  ignorantly  attempts  to  correct  the 
last  effect  by  combining  Opium  or  Laudanum  with 
the  Camphor,  he,  in  a  great  measure,  destroys  the 


TREATMENT.  105 


efficacy  of  the  latter,  besides  doing  direct  and  posi- 
tive injury  by  the  opiate. 

There  is  abundant  testimony  to  the  efficacy  of  the 
pure  Camphor  treatment  (by  small  doses)  from  all 
parts  of  Europe. 

Hahnernann  states,  that  at  Berlin  and  Magdeburg 
alone,  thousands  of  families  having  followed  his  in- 
structions respecting  the  treatment  by  Camphor, 
restored  those  of  their  members  who  were  attacked  by 
the  epidemic — restored  them  often  in*less  than  a 
quarter  of  an  hour.  This  method  was  said  to  be  em- 
ployed with  certainty  of  success  in  the  first  hour ; 
with  probability  in  the  following  hours.  Now,  it 
sometimes  fails,  oftener  among  children.  I  recom- 
mend the  trial  of  pellets,  and  not  lower  than  Camph. l, 
even  for  adults.  Probably  the  Camph.0  will  soon  be 
less  used. 

Hahnemann  at  first  advised  the  external,  in  con- 
nexion with  the  internal;  use  of  Camphor,  but  subse- 
quently found  it  unnecessary..  Indeed  it  not  only  is 
useless,  but  fills  the  room  with  effluvia  which  inter- 

9 

fere  with  subsequent  treatment. 

But  as  it  is  often  difficult  to  persuade  the  friends  of 
the  patient  to  wait  for  the  action  of  the  remedy,  they 
may  be  allowed  to  rub  with  a  flannel,  either  dry,  or 
moistened  with  alcohol,  or — what  is  better — with 
their  dry  hands.  They  may  also  be  allowed  to 
place  a  warm  brick  at  the  feet  of  the  patient — if  they 
are  cold — although  it  is  of  no  positive  use. 


106  EARLY 

Though  Camphor  has  not,  on  the  whole,  lost  any 
reputation  in  the  epidemic  of  1849,  yet  I  have  been 
informed  of  "several  instances  of  its  failure,  even 
when  given  under  the  above  favorable  circumstances, 
and  apparently  in  cases  to  which  it  was  appropriate 
— and  have  seen  it  and  other  remedies  fail,  where 
Laudanum  had  been  previously  given,  and  several 
hours  had  elapsed,  before  the  homoeopathic  physician 
was  called. 

From  the  general  utility  of  the  early  employment 
of  Camphor,  it  is  not  to  be  inferred  that  the  homoeo- 
pathic physician  will  usually  commence  with  it,  where 
the  family,  instructed  in  its  use,  has  given  many  do- 
ses of  it  previously  to  his  arrival.  His  course  will 
be  determined  by  a  consideration  of  the  totality  of 
the  symptoms. 

Though  the  Camphor  should  produce  immediate  re- 
lief, it  is  not  to  be  relied  on  for  a  permanent  cure, 
where  one  or  more  other  medicines  are  subsequently 
indicated  by  the  symptoms — as  will  often  be  the  case. 
After  such  improvement,  the  patient  will  be  safe  with 
other  appreciate  treatment,  but  not  always  without 
it. 

Camphor  is  a  remedy  which  is  imperfectly  proved, 
as  to  the  symptoms  which  it  is  capable  of  producing 
in  the  attenuated,  and  even  in  the  crude  state ;  and 
our  school  has  more  experience  of  its  use  in  cholera 
in  the  former  than  in  the  latter  condition.  These  are 
reasons  for  employing  it  in  a  form  less  attenuated 
than  that  adopted  for  other  medicines.  Another  rea- 


TREATMENT.  107 


son  is,  that  the  poison  of  cholera  is  probably  of  ani- 
malcular  origin,  and  Camphor  neutralizes  the  poison 
of  many  insects.* 

These  considerations  justify  the  use  of  drop  doses 
of  Camphor ;  and  the  use  of  such  doses,  so  far  as  the 
object  is  to  act  directly  on  a  poison  in  the  body,  af- 
fords no  evidence  of  our  inconsistency,  or  lack  of  con- 
fidence in  infinitissimal  doses,  when  we  employ  them 
to  act  directly  on  the  human  organism,  and  restore 
its  healthy  action.  Those  who  are  not  satisfied  with 
this  brief  explanation,  or  desire  a  more  extensive  ex- 
amination of  the  subject  of  antidotes,  and  the  use  of 
mechanical  and  chemical  means  and  large  doses,  in 


*  The  prevalent  opinion,  that  Camphor  is  a  medicine  which  does 
not  bear  much  attenuation,  has  not  been  established  by  experiments. 
Of  the  high  attenuation,  I  know  of  no  other  proving  than  the  fol- 
lowing : 

In  1849,  on  Tuesday  evening,  Feb.  22d,  at  twenty  minutes  often, 
I  took  a  few  dry  pellets  of  Boennenghausen's  Camphor  ySu,  and  ad- 
ministered the  same  dose  to  Dr.  H.  H.  Gator  and  Mr.  (now  Dr.) 
Brown.  In  twelve  minutes  I  had  cold  perspiration,  especially  on 
the  forehead  and  chest.  The  same  symptom  was  simultaneously  ex- 
perienced by  the  two  other  provers.  In  the  epidemic  of  the  follow- 
ing summer,  Dr.  B.  F.  Bowers  employed  Camph.  -°°  with  success  in 
many  cholera  cases,  and  was  as  well  satisfied  of  the  reality  of  its 
curative  action,  as  of  that  of  any  other  remedy.  He  frequently 
took  it  himself  when  he  experienced  any  premonitory  symptoms, 
but  never  in  any  other  form  than  the  200th,  during  the  epidemic.  In 
the  present  month,  April,  1854,  I  have  administered  Camph.  55,  with 
immediate  and  complete  success,  for  cholera  diarrhoea  with  milky 
discharges.  The  30th  and  lower  potencies  of  Camphor  have  been 
employed  successfully  by  Drs.  Barlow,  Bayard  and  Kirby. 


108  EARLY 

connection  with  homeopathic  treatment,  are  referred 
to  my  volume  on  "Principles."* 

In  conclusion  I  must  add,  that  the  large-  doses  of 
Camphor,  used  in  popular  and  allopathic  practice, 
dangerously  oppress  the  stomach  and  brain,  and  frus- 
trate the  cure. 


DIRECTIONS  FOR  THE  GENERAL  MANAGEMENT  OF  A 
CHOLERA  PATIENT. 

1.  Apply  no  camphor  externally,  and  use  no  exter- 
nal applications  of  any  kind. 

2.  Give  no  drinks  but  cold  water,  unless  the  pa- 
tient prefers  warm  toast  water,  which  is  the  case  in 
but  very  few  instances. 

3.  Ice  water  may  be  taken  as  frequently  as  the  pa- 
tient  desires  it.     It  is   useful   for   extreme   thirst, 
cramps,  colic,  vomiting  and  cold  skin. 

4.  The  food  should  consist  of  mutton  or  chicken 
broth,  with  no  seasoning  except  a  moderate  quantity 
of  salt.     Beef  broth   will  answer.     Oyster  soup  is 
not  allowed.     Great  care  should  be  used  in  regard  to 
diet  during  convalescence. 

5.  The  patient  should  lie  in  bed,  with  comfortable 
coverings. 

6.  If  the  weather  is  cool,  there  should  be  a  good 
fire,  which  will  allow  the  windows  to  be  kept  open  for 
ventilation. 

*  Vide,  "  Principles  of  Homoeopathy,"  Lecture  3d. 


TREATMENT.  109 


7.  The  patient  should  not,  however,  be  exposed  to 
cold  air.     If  compelled  to  rise,  he  should  be  covered, 
and  the  windows  closed. 

8.  He  should  rise  no  oftener,  and  move  no  more, 
than  necessary ;  as  motion  is  hurtful.     He  should,  if 
practicable,  be  provided  with  a  bed-pan,  instead  of 
being  compelled  to  rise. 

9.  No  glass  or  spoon  which  has  been  used  for  one 
medicine,  should  be  used  for  another,  until  it  has 
been  rinsed  with  clean  hot  water,  (without  soap,) 
then,  whilst  hot,  wiped  dry  with  a  clean  towel,  and 
allowed  to  stand  till  cool,  and  thus  become  more  per- 
fectly dried  by  its  own  heat.     Or  when  convenient,  it 
should  be  washed  with  hot  water,  and  wiped,  then 
heated  near  a  fire,  and  again  allowed  to  cool  before 
being  used  for  another  medicine. 


CHAPTER    VII. 
SYMPTOMS    AND    TREATMENT 

OF    THE 

VARIETIES  OF  CHOLERA. 


LAW  OF  CURE,  AND  REPETITION  AND  MAGNITUDE 
OF  DOSES. 

THE  skilful  Homoeopathic  physician  does  not  neg- 
lect the  teachings  of  clinical  experience ;  but  he  re- 
lies mainly  on  the  law,  that  any  disease,  in  its  curable 


110  TREATMENT 


stage,  can  be  cured  by  a  medicine  which  is  capable  of 
producing   a   sufficiently  large   group   of  symptoms 
similar  to  those  which  the  disease  itself  presents.* 
Judgment  is  required  in  regard  to  the  relative  im- 
portance of  symptoms ;  but  it  is  important  to  consult 
repertories  and  materia  medicas  with  regard  to  a 
great  number  of  the  symptoms  of  a  case,  and  to  com- 
bine as  many  as  possible,  and  thus  eliminate  the  false 
remedies  and  arrive  at  the  true  remedy  for  the  whole 
group,  and  consequently»for  the  disease  of  which  that 
group  is  the  index  or  exponent.     The  popular  error, 
that  a  knowledge  of  the  name,  essential  nature  and 
principal  seat  of  the  disease,  is  pre-requisite  to  a  suc- 
cessful treatment  of  it,  is  founded  upon  the  blind  na- 
ture of  allopathic  therapeutics.     Allopathy  has  no 
guide  but  the  name,  the  supposed  nature  and  the 
supposed  seat  of  the  malady :  and  if  any  one  who  has 
received  some  homoeopathic  light,  allows  himself  to 
be  still  led  by  the  blind,  he  will  fall  into  the  same 
ditch. 

The  usual  intervals  between  the  doses  of  attenuat- 
ed medicines  for  the  more  severe  varieties  of  Cholera 
are,  half  an  hour,  one  hour,  and  an  hour  and  a  half, 
according  to  the  violence  of  the  disease.  In  some 
violent  cases,  the  medicine  may  be  repeated  in  fifteen 
minutes.  But  we  are  not  to  suppose  that  the  good 
effect  is  ordinarily  increased  by  this  greater  frequency, 

*  For  proofs  of  the  truth  and  advantages  of  this  law,  see  my 
"  Principle!  of  Homoeopathy,"  Lecture  IV. 


OF    THE  VARIETIES.  Ill 

or  that  too  frequent  a  repetition  is  harmless.  Again, 
we  are  not  to  suppose,  that  the  operation  of  an  at- 
tenuated medicine  will  be  frustrated  by  the  occur- 
rence of  vomiting  at  the  end  of  several  minutes  after 
it  has  been  swallowed.  It  is  not  like  a  crude  drug. 
Some  portion  of  it  has  already  gone  to  every  part  of 
the  body ;  and  the  portions  which  have  entered  the 
circulation  have  nearly  as  much  power  as  the  whole 
dose. 

Vomiting  after  such  an  interval  does  not  render  a 
repetition  of  the  dose  necessary.  Neither  are  we  to 
suppose  that  the  dose  requires  to  be  repeated  on  ac- 
count of  the  patient's  having  taken  food  or  drink 
which  is  slightly  medicinal  or  antidotal.  It  is  not 
probable  that  the  action  of  an  attenuated  medicine 
can  be  entirely  frustrated  by  antidotes  taken  in  the 
crude  form.  The  attenuations  have  peculiar  power. 
Every  experienced  and  observant  homoeopathic  phy- 
sician knows,  that  less  than  a  billionth  part  of  a  grain 
of  common  salt,  will  manifest  its  specific  effects  in  an 
individual  who  is  taking  many  grains  of  crude  salt  at 
every  meal.  The  rule  of  three  fails  to  explain  the 
effect  of  such  an  infinitesimal  increase  in  the  quan- 
tity. The  inference  is  inevitable,  that  the  homoeopa- 
thic process  has  developed  immense  power.*  The 
existence  of  great  curative  power  in  the  homoeopathic 
attenuations  is  manifested  by  their  effects  on  cholera. 


*  For  other  proof's  of  this,  see  a  more  extensive  examination  of  the 
"power  of  small  doses,"  in  the  second  lecture  of  the  volume,  refer- 
red to  in  the  preceding  note. 


112  TREATMENT 


The  proper  attenuations  for  the  respective  medi- 
cines are  stated  in  the  Introduction.  They  are,  in 
most  of  them,  the  12th  or  30th.  They  may  be  given 
dry,  in  loaf  sugar  or  sugar  of  milk,  or  in  solution  in 
iced  water.  Iced  water  is  itself, a  remedy,  and  it 
may  be  given  to  the  patient  in  most  cases.  In  re- 
gard to  the  repetition  of  attenuated  medicines,  a  rule 
applicable  to  all  cases  of  Cholera  is — discontinue  the 
administration  of  medicine  as  soon  as  there  is  amend- 
ment, and  as  long  as  this  is  progressive. 

In  regard  to  dose  and  mode  of  administration,  con- 
sult Chapter  VI. 

In  the  case  of  camphor,  as  compared  with  other 
medicines,  the  dose  is  large  and  the  repetitions  fre- 
quent ;  for  it  is  unlike  all  other  medicines  in  not  re- 
quiring attenuation,  and  in  being  exceedingly  tran- 
sient in  its  action.  Hahnemann  directed  one  drop  of 
the  tincture  every  five  minutes ;  the  tincture  being 
made  by  dissolving  one  oz.  of  camphor  in  twelve  of 
alcohol.  Dr.  Quin  happened  to  use,  in  his  own  case, 
two-drop  doses  of  the  tincture,  made  in  the  propor- 
tion of  one  to  six,  and  finding  it  to  succeed,  used  it 
for  others.  Hartmann  recommends  the  proportion  of 
one  to  twenty,  and  the  dose  one  or  two  drops,  every 
two  or  five  minutes.  The  tincture  directed  by  the 
allopathic  pharmacopeias  and  found  in  the  drug- 
stores, is  generally  one  to  eight,  sometimes  one  to 
sixteen.  There  is  probably  no  better  rule,  than  to 
dissolve  one  oz.  of  camphor  in  ten  oz.  (i.  e.  2%  gills) 


OP    THE  VARIETIES.  113 

of  alcohol.*  The  ordinary  dose  will  be  one  drop  every 
five  minutes.  In  some  cases,  the  dose  may  be  in- 
creased to  two  drops,  or  the  intervals  reduced  to  two 
or  three  minutes.  Give  the  tincture  in  sugared  wa- 
ter, iced  or  at  least  cold.  As  camphor  is  one  of  the 
most  powerful  and  general  antidotes  to  other  medi- 
cines, the  patient  must  not  take  these  from  any  glass 
or  spoon  which  has  contained  it,  nor  must  the  odor  of 
it  be  in  the  room  after  he  commences  other  medi- 
cines. 

The  forms  described  in  this  Chapter  are  those 
which  the  Cholera  most  frequently  presents.  Some 
of  them  are  occasionally  combined.  The  Homoeopa- 
thic physician  will  know  how  to  adapt  his  treatment 
to  the  different  shades  and  combinations  of  these  va- 
rieties.t  He  will  apply  the  Materia  Medica,  and  the 
law  similia  similibus  curantur.  The  accompanying 
Repertories  will  aid  in  the  selection  of  the  remedies. 


SYMPTOMS     OF    THE    FIRST  VARIETY,    CHO- 
LERA   DIARRHCEICA   INTESTINAL,   OR 
DIARRHCEIC    CHOLERA. 

This  is  the  form  in  which  diarrhoea  is  a  prominent 
symptom.  At  first  there  is  a  simple  diarrhoea ;  las- 

*  This  is  the  strength  of  the  tincture  which  the  publisher  (Win. 
Radde)  will  sell  with  this  book. 

t  The  term  varieties,  is  not  used  in  this  book  to  denote  unusual 
forms  of  this  disease,  but  the  more  usual  forms  of  the  Cholera  con- 
sidered as  itself  a  species. 


114  TREATMENT 


situde  in  the  legs  ;  rumblings  ;  tongue  moist,  clean  or 
a  little  coated  ;  sometimes  it  is  pasty,  or  gluey,  so  as 
to  adhere  to  the  finger  when  applied  to  it.  The  eva- 
cuations, at  first  composed  of  digested  food  or  feculent 
matters,  shortly  become  yellowish  brown  or  watery : 
after  a  few  hours  or  a  few  days,  they  have  the  ap- 
pearance of  barley-water,  rice-water,  or  of  whey  with 
little  flocks  of  soap  distributed  through  it,  or  of  milk- 
porridge  mixed  with  water.  The  whiteness  appears 
to  depend  on  minute  flocculi  of  whitish  mucus,  with 
some  larger  lumps  of  the  same,  sometimes  as  large 
as  a  pepper-corn  and  of  a  yellowish-white  color. 
Each  stool  is  preceded  by  great  noise  and  movements 
in  the  intestines.  The  noise  is  sometimes  like  the 
rumbling  of  gas,  at  others  like  that  of  a  running  li- 
quid. There  is  a  livid  circle  around  the  eyes,  or  dark 
color  of  the  whole  face,  coldness  of  the  hands  or 
tongue,  prostration  of  muscular  strength,  and  feeble- 
ness of  pulse  ;  sometimes  nausea  or  cramps.  Some 
vomiting  may  take  place,  after  the  diarrhoea  has  con- 
tinued a  considerable  time  without  appropriate  treat- 
ment. 

If  this  form  of  Cholera,  although  it  should  amount 
only  to  a  slight  cholerine,  is  mistaken  for  an  ordinary 
diarrhoea  and  improperly  treated,  there  is  great 
danger  of  its  suddenly  assuming  a  much  graver  form  : 
vomiting  and  violent  spasms  may  set  in,  and  collapse 
and  death  close  the  scene.  This  alarming  revolution 
in  the  disease  may  occur  when  the  evacuations  have 
not  caused  much  debility  or  interfered  with  the  usual 


OF  THE  VARIETIES.  115 

avocations.  In  Europe 'and  America,  this  diarrhoeic 
form  is  the  most  frequent,  especially  in  places  and 
times  in  which  Cholera  does  not  rage  in  its  greatest 
intensity.  The  most  perfect  and  severe  forms  give 
no  such  warning,  even  in  Europe  and  America. 

In  one  sense,  the  premonitory  diarrhoea  is  a  part 
of  the  diarrhoeic  variety  of  Cholera.  If  a  line  can 
be  drawn  between  them,  it  is  probably  where  the 
discharges  change  from  the  foecal  to  the  liquid  cha- 
racter. The  treatment  is  similar. 


TREATMENT    OF    DIARRHCEIC     CHOLERA.* 

^^ 

If  Camphor  does  not  soon  give  relief,  we  are  to 
resort  to  other  medicines,  generally  to  Phosphorus, 
Phosphoric-acid  or  Veratrum.  I  have  employed 
them  all  with  success.  The  Phosphoric-acid  is  to 
be  preferred  when  there  is  a  gluey  matter  on  the 
tongue,  or  cramps  in  the  upper  arm  or  fore-arm  or 
in  the  wrists  or  hands,  or  if  the  stools  are  yel- 
lowish and  the  evacuations  painless.  Give  Phos- 
phorus when  there  is  a  white  or  brown  coat  on  the 
tongue  and  the  evacuations  attended  with  griping  or 
colicky  pains,  or  with  nausea.  Give  Veratrum  when 
the  coat  on  the  tongue  is  yellow  and  the  diarrhoea 
painful.  In  some  cases,  Arsenicum,  Mercurius  or 
Secale  may  be  indicated. 

*  See  also  Chapter  VI,  section  1st,  for  the  treatment  of  its  first 
stage. 


116  TREATMENT 


However,  Phosphor,  Phosphoric-acid  or  Verat., 
generally  cure ;  and  they  may  often  be  given  at 
first,  without  the  previous  administration  of  Cam- 
phor, in  this  form  of  Cholera.  When  the  evacua- 
tions are  very  copious,  liquid  and  frequent,  Camphor 
should  not  be  given  so  many  times  before  resorting 
to  other  medicines.  Put  two  or  three  globules  of  the 
30th  attenuation  of  Phosphorus,  or  of  the  3d  attenu- 
ation of  Phosphoric-acid,  in  a  little  sugar  of  milk, 
and  place  them  on  the  patient's  tongue  ;  or  give  them 
in  solution,  in  the  manner  described  in  Chapter  VI. 
After  two  or  three  doses  of  Phos-ac.  3,  if  the  in- 
dications for  Phos.-ac.  remain,  it  will  often  be  useful 
to  employ  the  30th.  A  dose  of  the  appropriate  remedy 
may  be  given  after  each  evacuation,  if  it  is  copious,  or 
every  second  evacuation,  if  they  are  small. 


SYMPTOMS      OF     THE     SECOND     VARIETY, 
CHOLERA  GASTRICA,  GASTRIC  CHOLERA. 

This  form  of  Cholera  is  characterized  by  frequent 
or  almost  continual  vomiting,  but  is  often  accompa- 
nied by  many  symptoms  of  other  varieties.  The 
matters  at  first  thrown  out  consist  of  the  food  which 
the  stomach  happened  to  contain,  or  the  liquids 
which  had  been  swallowed.  They  are  usually  thrown 
up  with  a  sudden  jerk,  without  previous  retching. 
The  vomiting  is  sometimes  preceded  for  a  short  time 
by  nausea.  There  is  no  diarrhoea,  or  only  one  or 
two  evacuations  at  the  onset.  The  urine  is  scanty. 


OF    THE    VARIETIES.  117 

The  gastric  variety  of  Cholera  is  neither  the  most 
frequent  nor  the  most  dangerous.  When  the  epi- 
demic prevails,  this  form  may  he  excited  by  flatulent 
vegetables  or  other  indigestible  food. 


TREATMENT  OF  GASTRIC  CHOLERA. 
The  principal  remedies  are  Camphor  and  Vera- 
trum.  Camphor  will  ordinarily  be  proper  at  the 
onset ;  one  drop  every  five  jrinutes.  If  relief  is  not 
soon  obtained,  give  Veratrum  12,  at  the  usual  inter- 
vals, unless  some  other  remedy  is  more  indicated  by 
the  character,  conditions  or  concomitants  of  the  vomit- 
ing.* If,  by  the  effect  of  the  Veratrum  or  Ipecac., 
the  vomiting  cease,  but  the  other  symptoms  remain, 
and  there  is  great  weight  at  the  stomach  and  pains 
in  the  intestines  and  head,  then  have  recourse  to 
Nux  30.  But  if  the  disease  is  not  checked,  give 
Verat.  30,  or  other  medicines  according  to  the  indi- 
cations. To  Cholera  excited  by  anger,  and  attended 
with  either  vomiting  to  diarrhoea,  Cham.  12  is  appro- 
priate. 


SYMPTOMS     OF     THE     THIRD      VARIETY, 

CHOLERA  SPASMODICA,  SPASMODIC 

CHOLERA. 

This  form  is  especially  characterized  by  cramps 
and  other  spasms.     The   principal   symptoms   are, 


'  Examine  the  repertories  to  decide  between  these,  or  to  deter- 
mine whether  some  other  remedy  is  preferable. 

6* 


118  TREATMENT 


contractions  and  cramps  in  the  toes  and  fingers ; 
afterwards,  cramps  in  the  calves,  or  convulsive  move- 
ments in  the  muscles  of  the  fore-arm,  and  legs ; 
then  spasms  in  the  upper  arms  and  thighs,  and  some- 
times fixed  spasms  in  the  chest,  neck  and  jaw,  re- 
sembling those  of  locked  jaw  or  tetanus.  The  con- 
striction of  the  chest  is  preceded  by  vomiting.  Neither 
vomiting  nor  diarrhoea  frequently  occur  in  this  varie- 
ty ;  but  it  may  succeed  a  neglected  diarrhoea,  and 
be  ushered  in  by  a  single  copious  vomiting,  and  at- 
tended by  occasional  retchings. 

In  some  cases,  there  are  first  cramps  in  the  calves 
of  the  legs  ;  then  tonic  spasms  of  the  whole  of  both 
inferior  extremities,  soon  extending  in  succession 
to  the  abdomen,  stomach,  chest  and  throat ;  the  in- 
ferior limbs  remaining  spasmodically  extended  and 
extremely  stiff  and  hard,  and  affected  with  excruciat- 
ing pain  ;  a  hard  swelling  at  the  stomach ;  spasms  of 
the  muscles  of  the  jaw,  attended  with  grating  of  the 
teeth  ;  respiration  almost  arrested ;  sense  of  extreme 
suffocation  ;  apprehension  of  impending  dissolution  ; 
deglutition  difficult,  sometimes  impossible.  The 
spasms  at  length  relax,  and  the  patient  for  a  few 
minutes,  is  free  from  pain.  Then  the  spasms  and 
the  pain  return  with  their  former  severity. 


TREATMENTOF    SPASMODIC  CHOLERA. 

The  principal  remedies  are  Camphor,  Cuprum 
and  Veratrum.  Give  a  drop  of  Camphor  every 
five  minutes.  During  the  paroxysms,  if  they  are  ex- 


OF    THE    VARIETIES.  119 

tremely  severe,  we  may  give  two  drops  at  a  dose,  or 
repeat  one  drop  every  two  or  three  minutes.  The 
remedy  next  to  be  employed  for  removing  the  re- 
mains of  the  spasms  and  preventing  their  return  is 
ordinarily  Cuprum  30.  Give  it  in  solution,  or  dry 
in  doses  of  two  or  three  globules,  and  repeat  it  many 
times  at  intervals  of  half  an  hour,  or  an  hour,  if  ita 
salutary  effect  is  not  manifested.  If  necessary,  then 
give  Veratrum  (12th  then  30th)  in  repeated  doses,  or 
other  medicines  according  to  the  different  indications. 
Cuprum  may  be  given  at  the  onset  of  the  spasms, 
provided  their  character  and  concomitants  indicate 
its  use  decidedly  more  than  that  of  Camphor.  Vide 
Cholera  Repertory. 


SYMPTOMS    OF   THE    FOURTH    VARIETY, 
CHOLERA   SICCA,    DRY   CHOLERA. 

There  is  no  diarrhoea  nor  vomiting.  Sometimes 
the  attack  is  first  manifested  by  a  blackish  color  of 
certain  parts,  as  the  ends  of  the  fingers,  whilst  the 
general  strength  is  not  seriously  impaired.  In  the 
severer  forms,  there  is  a  sudden  prostration  of  the 
vital  powers  ;  the  urine  is  suppressed  ;  tongue  some- 
times blue  or  blackish  ;  the  eyes  up-turned  and  fixed  ; 
coldness  of  the  surface  of  the  whole  body,  which  be- 
comes covered  with  a  cold,  sticky  sweat ;  the  face 
and  limbs  have  a  violet  blue  color.  The  voice  and 
pulse  fail.  This  variety  requires  the  most  prompt 
attention . 


120  TREATMENT 


TREATMENT  OF  DRY  CHOLERA. 

The  first  remedy,  as  in  other  varieties  of  Cholera, 
is  Camphor.  In  this  variety,  it  is  especially  required, 
for  arousing  the  nervous  system.     Repeat  it  in  doses 
of  one  or  two  drops,  every  five  minutes.      Then,  if 
necessary,  give  Veratrum  every  half  hour,  or  hour, 
or  hour  and  a  half.    If  the  cramps  and  vomitings  have 
entirely  ceased,  if  the  patient  is  cold,  blue  and  pulse- 
less, i.e.  collapsed — Carbo-v.*°,  two  or  three  glo- 
bules.    In  this  state  of  complete  asphyxia,  some  re- 
commend hydrocianic  acid,    3d    attenuation,     every 
hour  or  two.     We  recognise  the  effect  of  these  me- 
dicines  by   the   pulsations   becoming   sensible,  and 
sometimes  by  a  return  of  the  cramps,  vomitings  or 
diarrhoea;  symptoms  which  are  then  to  be  treated 
by  Veratrum  or   Cuprum,  or  some  other  remedy, 
according  to  the  indication. 


SYMPTOMS    OF    THE    FIFTH    VARIETY, 
CHOLERA  ACUT  A,    ACUTE  CHOLERA. 

In  this  variety  the  nervous  centres  seem  to  be  ef- 
fected in  the  first  stage.  Yet  in  its  course  it  simu- 
lates the  form  of  some  other  varieties,  and  like  them, 
unless  checked,  ends  in  asphyxia  and  death. 

The  patient  at  first  feels  as  if  he  were  stunned,  or 
has  a  sensation  of  weight  in  the  head,  or  vertigo ; 
oppression  of  the  chest ;  numbness  of  the  arms  and 
legs.  Afterwards  there  are  rumblings  in  the  in- 


OF    THE    VARIETIES.  121 


testines  ;  heat  of  the  body,  pulse  rapid  and  feeble  ; 
nausea,  retching  or  vomiting ;  bilious  or  watery 
diarrhoea  ;  suppression  of  urine  ;  tongue  cold  ;  voice 
altered;  face  yellowish,  with  a  dark  blue  circle 
around  the  eyes  ;  prostration  ;  spasms,  at  first,  in 
the  feet  and  hands,  afterwards  extending  to  the  arms 
and  legs,  which  become  dark-blue  and  cold  ;  the  eyes 
tarnished  and  sunk  in  their  orbits.  The  diarrhoea 
and  cramps  cease,  and  the  disease  in  its  later  stage 
runs  into  the  form  of  dry  Cholera,  characterized  by 
cold  sweats,  insensible  pulse,  and  general  blueness — 
i.  e.  by  collapse. 

The  above  descriptions  of  the  dry  and  acute  Cho- 
lera, are  extracted  mainly  from  the  treatise  of  Dr. 
F.  F.Quin.  In  both,  the  strong  impression  of  the  poison 
on  the  nervous  system,  seems  to  produce  an  unusu- 
ally great  and  early  change  in  oxygenation  and  the 
constitution  of  the  blood.  There  is  probably  no  im- 
propriety in  applying  the  term  acute  to  most  of  those 
cases  which  without  being  dry,  are  sudden  in  their 
invasion  and  rapid  in  their  course.  Such  cases  not 
unfrequently  present  complications  which  prevent 
their  being  embraced  in  any  other  single  class,  un- 
less we  should  add  a  new  one  to  those  here  enume- 
rated. 


TREATMENT   OF   ACUTE   CHOLERA. 
Give  Veratrum ;  at  first  the  12th,  in  persons  of 
vigorous  constitution,  and  after  three  doses,  the  30th, 


122  TREATMENT 


in  the  quantity  and  at  the  intervals  before  described. 
In  cases  of  persons  of  feeble  constitution,  give  one 
dose  of  the  12th,  and  follow  it  by  as  many  of  the  30th 
as  shall  be  necessary. 

If  in  this  or  in  any  other  variety  of  Cholera,  there 
is  severe  burning  in  any  part  of  the  alimentary- 
canal,  with  violent  colic,  and  great  weakness  or  rest- 
lessness, give  Arsenicum  80.  If  the  colic  proves  ob- 
stinate, give  an  enema  of  ice-water.  Though  Vera- 
trum  is  in  general  the  grand  remedy  for  this  some- 
what complicated  variety,  yet  it  will  often  be  neces- 
sary to  consult  the  repertory,  and  determine  the  re- 
medy by  groups  of  symptoms.* 


SYMPTOMS    OF    THE    SIXTH    VARIETY,   ; 
CHOLERA     GASTRO-ENTERICA, 
GASTRO-ENTERIC    CHOLERA. 

This  is  a  kind  of  combination  of  the  gastric  and 
diarrhoeic  varieties ;  yet  being  not  unfrequent  in  its 
occurrence,  it  merits  a  distinct  consideration.  It  is 
characterized  by  vomiting  and  diarrhoaa,  almost  si- 
multaneous in  their  commencement,  and  nearly  equal 
in  their  intensity  and  duration.  These  evacuations 
from  the  stomach  and  intestines  agree  in  another 
respect :  viz.  in  consisting  at  first  of  the  usual  con- 
tents of  those  cavities  respectively,  (i.  e.  food  being 
vomited,  and  fcecal  matter  dejected,)  and  in  soon  be- 

*  The  treatment  of  the  dry  and  acute  varieties,  is  taken  mainly 
from  the  treatise  of  Dr.  F.  F.  Quin  of  London. 


OF    THE    VARIETIES. 


123 


coming  thinner,  afterwards  watery,  and  ultimately 
assuming  the  rice-water  appearance.  Although  this 
combination  of  upward  and  downward  discharges  is 
characteristic  of  this  variety,  there  may  be  some 
cramps,  and  great  coldness  of  the  body,  and  the 
patient  may  be,  within  a  few  hours  after  the  attack, 
in  the  blue  and  pulseless  condition  of  collapse. 


TREATMENT  OF  G  AS  TRO-E  NTE  RI  C 
CHOLERA. 

The  principal  remedy  is  Veratrum,  in  the  doses 
and  at  the  intervals  before  mentioned.  If  a  dose  or 
two  of  the  12th  is  given  at  first,  the  30th  should  be 
given  subsequently. 

If  the  treatment  is  commenced  very  early,  Cam- 
phor will  be  appropriate,  and  ordinarily  sufficient. 
Dose,  one  drop  every  five  minutes.  When  the  stools 
become  exceedingly  copious  and  liquid,  Veratrum  is 
in  most  cases  to  be  used.  If  there  is  complication 
of  other  symptoms,  the  groups  may  indicate  some 
other  remedy. 

SYMPTOMS  OF  THE  SEVENTH  VARIETY, 
CHOLERA  DYSENTERICA,  DYSENTERIC 

CHOLERA.* 

?    This   variety   commences  with  the   symptoms  of 
diarrhosic    Cholera,    and    gradually    becomes    more 

*  Dr.  Quin,  from  whom  the  above  classification  is  in  part  taken, 
comprises  in  "  Dysenteric  Cholera,"  what  is  here  named  Diar- 
rhueic,  if  he  does  not  restrict  it  to  that. 


124  TREATMENT 


dysenteric.  The  diarrhoea  from  the  outset  is  attended 
with  pain  in  the  abdomen.  The  stools,  copious  and 
watery,  presently  acquire  the  rice-water  character. 
After  some  time  they  diminish  in  quantity,  and  pre- 
sent, in  addition  to  the  watery  and  ricey  portions, 
some  mucus,  which  still  later  becomes  sanguineous, 
but  is  still  accompanied  by  ricey  and  watery  por- 
tions. If  the  disease  continue  some  days,  the  ricey 
evacuations  are  replaced  by  others  of  bloody  mucus 
or  blood.  Cramps  of  the  feet  may  exist  early  in  the 
second  stage,  and  even  precede  the  attack  as  a  pre- 
monitory symptom. 

Many  cases  of  dysenteric  Cholera  occurred  in 
1849.  They  were  distinguishable  from  dysentery 
(many  cases  of  which  also  occurred  in  the  same  epi- 
demic) by  the  Cholera  symptoms  which  predominated 
in  the  earlier  stages. 

On  account  of  the  frequent  occurrence  of  this  form 
as  compared  with  all  others  of  an  inflammatory  char- 
acter, and  the  peculiarity  in  the  treatment  required, 
there  is  a  practical  advantage  in  giving  it  a  distinct 
consideration  and  name.  It  is  therefore  placed  by 
itself  in  this  edition.  It  is  not  usually  in  any  re- 
markable degree,  a  febrile  disease :  the  depression 
of  the  vital  forces  by  the  Cholera  proper,  seems  in 
many  cases  to  overbalance  the  general  excitement 
which  the  associated  inflammation  of  the  mucous 
membrane  of  the  large  intestine  tends  to  produce. 
And  this  inflammation  when  uncomplicated,  is  sel- 
dom attended  with  as  much  fulness  of  pulse  and  pains 


OF  THE  VARIETIES.  125 

in  various  parts,  as  characterize  many  other  inflam- 
mations and  fevers.  Yet  there  are  cases  where  this 
variety  is  complicated  with  the  succeeding.  There 
may  be  similar  complications  in  the  case  of  other 
varieties.  I  am  not  insensible  to  the  defects  of  this 
and  all  classifications,  of  the  disease,  but  deem  it 
practically  useful  to  adopt  one  that  is  approximately 
correct. 


TREATMENT  OF  DYSENTERIC  CHOLERA.  ' 

The  principal  remedies  for  this  variety,  are  Cam- 
phor, Veratrum,  Mercurius-vivus,  and  Sulphur — 
in  the  above  order. 

There  being  an  inflammation  of  the  mucous  mem- 
brane of  the  large  intestine,  we  should  make  but  a 
sparing  and  cautious  use  of  Camphor.* 

Give  three  or  four  doses  of  Camphor  3,  at  inter- 
vals of  a  quarter  or  half  an  hour,  or,  if  this  is  not  at 
hand,  as  many  quarter-drop  doses  of  the  tincture ; 
then  Veratrum  I2  or  30,  until  the  evacuations  be- 
come small  and  bloody;  then  Mercurius  12,  followed 
after  some  time  by  Mercurius  30.  After  amendment 
of  the  dysenteric  portion  of  the  disease,  commences, 
the  cure  is  to  be  completed  by  Sulphur  30. 

*  I  think  a  similar  precaution  in  regard  to  Camphor,  is  advisable 
in  treating  children  in  cholera  generally.  Nearly  all  the  fatal  cases 
which  I  have  heard  of  as  occurring  after  an  early  use  of  Camphor, 
have  been  among  children  under  twelve  years  of  age.  I  would  ad- 
vise that  in  the  cases  of  children,  Camphor  be  not  employed  lower 
than  the  third  dilution. 


126  TREATMENT 


Sometimes,  when  there  is  inflammatory  fever,  two 
or  three  doses  of  Aconite  will  be  required  before  the 
Mercurius,  or  during  a  temporary  suspension  of  the 
use  of  the  latter. 


SYMPTOMS  OF  THE  EIGHTH  VARIETY,   CHOLERA  FE- 
BRILIS,    FEBRILE  CHOLERA. 

In  some  instances,  cholera  is  complicated  with  fe- 
ver. This  is  distinguishable  from  other  febrile  disea- 
ses, by  the  watery  and  ricey  evacuations,  or  the 
nausea  vomitings  and  spasms  ;  and  from  other  forms 
of  cholera,  by  the  frequency,  hardness,  and  fulness  of 
the  pulse.  The  temperature  of  the  body  is  generally 
above  the  normal  standard,  that  of  the  hands  and 
feet,  sometimes  below.  Pains  in  the  small  of  the 
back,  hips,  limbs,  head,  and  abdomen.  Redness  of 
the  eyes,  tongue,  or  fingers. 


TREATMENT  OF  FEBRILE  CHOLERA. 

In  febrile  cholera,  give  but  little  Camphor. 
For  a  short  time  use  Veratrum,  or  other  remedies 
adapted  to  the  purging  vomiting,  or  cramps,  if  either 
is  severe.  Then  Aconitum  IS  or  *°  in  solution,  a 
dose  once  in  two  or  three  hours,  if  the  pulse  is  hard, 
full  and  rapid,  and  there  is  great  thirst,  and  heat  of 
skin.  Otherwise  use  Rhus-radicans  80,  for  the  rheu- 
matic-like pains.  This  last  remedy  will  be  especially 


OP    THE   VARIETIES.  127 

indicated  if  the  tip  of  the  tongue  is  red.  Then  Bell. 
80,  Bry.  *°,  or  Canth.  *°,  according  to  the  symptoms 
and  the  organ  affected.  The  accurate  selection  of  the 
remedy  in  these  cases  can  be  made  only  hy  a  homoeo- 
pathic physician. 

The  foregoing  varieties  are  in  some  cases  well 
marked,  in  others  not.  There  is  an  advantage  in  at- 
tending to  them  ;  though  the  homoeopathic  physician 
who  prescribes  for  the  symptoms,  will  not  deem  it 
necessary  to  designate  the  variety.  This  will  often 
be  impracticable,  especially  if  he  is  called  when  the 
cases  are  so  advanced  as  to  confound  varieties  which 
were  originally  distinct.  In  one  sense,  the  variety 
may  change  with  the  stage. 


CHAPTER    VIII. 
SYMPTOMS    AND    TREATMENT 

OF    THE 

STAGES  OF  CHOLERA. 


A  case  of  either  of  the  foregoing  varieties  is  not 
usually  divisible  into  distinct,  well-defined  stages ; 
but  we  may  enumerate  four  stages  ;  some  of  them  be- 
ing oftener  present  or  more  distinct  or  durable  in  one 
variety,  and  some  in  another.  They  are  :  1st.  The 
incipient  Stage,  or  Stage  of  Invasion :  2d.  The 


128  TREATMENT 


Active  Stage,  or  Stmge  of  Full  Development :  3d. 
The  Stage  of  Collapse:  and  4th.  The  Stage  of 
Reaction. 


FIRST  STAGE,  STAGE  OF  INVASION. 

This  is  usually  longest  in  the  diarrhceic  variety; 
in  which  it  may  continue  from  one  hour  to  several 
days.  The  stools,  though  they  may  he  watery  and 
whitish^  are  not  profuse.  In  the  gastric  variety,  this 
stage  may  present  a  transient  nausea,  or  a  few  loose 
foecal  stools  ;  in  the  spasmodic  variety,  diarrhoea,  or 
one  or  two  vomitings  ;  in  the  acute  variety,  vertigo ; 
in  the  gastro-enteric  variety,  nausea. 

When  cholera  prevails,  the  above  symptoms  are 
generally  due  to  the  action  of  its  poison.  This  is 
evident  from  their  general  prevalence  during  the  epi- 
demic, their  amenability  to  cholera  remedies,  and  the 
formidable  and  unequivocal  phases  which  they  fre- 
quently assume,  when  nature  is  unaided. 

There  are  two  modes  of  considering  these  symp- 
toms— either  as  constituting  a  milder  form,  or  an 
earlier  stage.  The  latter  is  here  preferred.  Some 
of  these  cases  would  stop  in  this  stage,  others  be- 
come fully  developed,  and  finally  fatal.  No  power  of 
diagnosis  could  at  first  separate  them  into  two  class- 
es, founded  on  their  inherent  tendencies.  Could  we 
distinguish  those  which  would  spontaneously  prove 
abortive,  we  would  exclude  them,  even  from  the  first 


OF    THE    STAGES.  129 


stage.  But  that  distinction  is  impracticable.  With- 
out any  assumption  in  regard  to  their  nature,  the 
event  under  treatment,  will  subsequently  decide 
whether  they  assume  a  form  more  complicated  and 
severe ;  and  as  it  requires  a  certain  number  and  se- 
verity of  symptoms,  to  constitute  the  disease  in  its 
more  formidable  and  popular  sense,  we  never  include 
in  our  cholera  reports,  the  cases  cured  in  this  stage 
of  invasion.* 

The  principal  remedies  in  the  first  stage  are : 
Camphor,  Phosphorus,  Phosphoric-acid,  and  Vera- 
trum. 


SECOND    STAGE,    STAGE    OF   FULL   DE- 
VELOPMENT. 

This,  in  the  diarrhceic  variety,  is  characterized  by 
the  profuse  or  frequent  rice-water  evacuations  ;  in  the 
gastric  variety,  by  the  vomiting  of  similar  matter ; 
in  the  spasmodic  variety,  by  severe  cramps  or  other 
spasms  ;  in  the  dry  variety,  the  first  two  stages  may 
be  scarcely  perceptible,  unless  the  first  is,  by  the  dark 
color  of  certain  parts,  or  the  coldness  of  the  tongue ; 
in  the  acute  variety,  there  may  be  a  livid  appearance 
under  the  eyes,  vomiting,  or  rumblings  and  liquid 
stools.  In  the  gastro-enteric  variety,  there  is  pro- 
fuse vomiting  and  diarrhoea ;  in  the  dysenteric  varie- 

*  In  an  essay  published  in  the  appendix  to  this  book,  this  stage  is 
designated  by  the  convenient  term  Ckoleroid.  This  term  includes 
Cholerine,  but  has  the  advantage  of  greater  comprehensiveness. 


130  TREATMENT 


ty,  pain  and  tenderness  of  the  abdomen,  and  watery, 
ricey,  and  bloody-mucous  discharges. 

The  stage  of  full  development  has  usually  one  of 
two  terminations ;  viz.,  either  collapse,  or  convales- 
cence. 

In  fully  developed  cholera,  the  principal  remedies 
are :  Camphor,  Veratrum,  Cuprum,  Phosphorus, 
Phosphoric-acid,  and  Arsenicum. 

It  is  the  commencement  of  this  stage,  that  is  allud- 
ed to  in  Chapter  VI,*  as  "a  decided  attack."  For 
the  details  of  its  early  treatment,  the  second  section 
of  that  chapter  is  to  be  consulted — also  the  Reperto- 
ries. 


THIRD    STAGE,    STAGE    OF    COLLAPSE. 

This  stage  of  collapse  may  have  the  same  charac- 
ter in  every  variety  of  Cholera,  and  in  its  principal 
features  it  is  similar  in  all  varieties.  The  term  col- 
lapse is  used  to  designate  a  certain  collection  of  symp- 
toms, including  pulselessness ;  cold,  blue  and  shri- 
velled skin ;  the  voice  reduced  to  a  whisper ;  the 
urine  and  other  secretions  suppressed,  and  the  face 
presenting  a  certain  appearance  called  Choleric.  The 
term  facies  cholerica  is  used  to  denote  a  face  cold, 
livid  and  shrunk,  and  often  anxious,  the  eyes  sunk  in 
the  orbits,  and  upturned,  or  fixed,  as  if  in  vacant 
staring.  The  vox  cholerica,  which  belongs  chiefly  to 

*  Page  102. 


OF    THE    STAGES.  131 

this  stage,  is  a  voice  hoarse,  feeble,  whispering,  or 
almost  imperceptible. 

The  duration  of  the  third  stage,  varies  from  two 
hours  to  two  days.  It  has  one  of  three  terminations  ; 
viz.,  either  death,  convalescence,  or  a  disease  which  is 
inflammatory,  congestive,  or  typhus.  When  death 
occurs  from  Cholera,  it  is  usually  at  the  termination 
of  the  third  stage,  sometimes  of  the  fourth.  The  re- 
turn of  a  perceptible  pulse,  and  of  warmth,  although 
attended  with  a  renewal  of  the  vomiting  and  diar- 
rhoea, are  favorable*  signs ;  though  even  after  this 
partial  reaction,  there  may  be  a  relapse  into  asphyxia. 

If  the  collapse  is  complete,  the  principal  remedies 
are  Cuprum,  Arsenicum,  Carbo-vegetabilis,  and  /Se- 
cale.  When  the  collapse  is  only  incipient  or  partial, 
Camphor  and  Veratrum.  These  may  also  be  re- 
quired for  a  while  in  complete  collapse,  if  they  have 
not  been  resorted  to  in  an  earlier  stage  of  the  same 
case. 


FOURTH  STAGE,  STAGE  OF  REACTION  AND  SECOND 
ARY  AFFECTIONS. 

The  secondary  affections  which  ensue  on  reaction, 
are  congestive,  inflammatory,  or  febrile.  The  fourth 
stage  proper,  i.  e.,  reaction  attended  with  these  seri- 
ous diseases,  has  seldom  any  existence  after  a  good 
homoeopathic  treatment  of  Cholera  proper ;  though 
there  will,  in  some  cases,  be  dysuria.  The  affections 


132  TREATMENT 


to  be  most  apprehended  after  allopathic  treatment, 
are,  inflammation,  or  congestion  of  the  brain,  stomach, 
intestines,  or  lungs  ;  or  typhoid  fever. 

So  far  as  there  is  a  partial  reproduction  of  the 
symptoms  of  the  second  stage,  which  had  disappear- 
ed during  the  collapse,  a  recurrence  to  the  remedies 
of  the  second  stage  will  be  necessary  in  the  fourth. 
But  for  the  new  symptoms  following  reaction,  use 
other  remedies.  For  the  irritation  of  the  bladder,  at- 
tended with  painful  urination,  use  Cantharis  ao,  eve- 
ry hour  or  two,  whilst  the  symptoms  remain  urgent. 

In  most  of  these  inflammations,  however,  we  may 
give  two  or  three  doses  of  Aeon.  24,  at  intervals  of 
an  hour,  and  then  follow  it  by  the  remedy  adapted  to 
the  symptoms,  and  the  organ  affected  ;  repeating  this 
last  medicine  much  less  frequently.  If  it  is  the  brain 
that  is  affected,  the  remedy  will  generally  be  Bella- 
donna 80 ;  if  the  lungs,  Bryonia  30,  in  some  cases 
followed  by  Rhus  3  °  ;  if  the  stomach  or  intestines, 
Nux  3  °,  and  sometimes  Bry.  3  °  ;  if  the  bladder,  Can- 
tharis 30.  This  last  is  also  the  remedy  where  there 
is  inflammation  in  the  lower  intestines,  attended  with 
burning,  tenesmus,  and  bloody  stools.  For  the  ty- 
phus or  typhoid  fever,  Bryonia,  and  sometimes 
Phosphoric-acid,  may  be  used ;  but  the  principal 
remedy  is  Rhus-radicans* 

*  I  deem  it  due  to  the  profession  as  well  as  to  myself,  to  state, 
that  the  Note  on  this  plant,  inserted  without  my  consent  or  know- 
ledge, in  the  Appendix  to  the  American  edition  of  Jahr's  Sympto- 


OF    THE    STAGES.  133 


I  will  take  this  occasion  to  make  a  remark  on  a 
topic,  not  discussed  in  either  of  the  notes  above  re- 
ferred to.  The  Rhus-tox.  which  Hahnemann  tried,  was 
an  exotic,  and  hence  probably  did  not  possess  as  much 
power  as  a  plant  of  the  same  species  found  growing 
in  its  native  soil  in  America.  Dr.  Wallace,  a  scien- 
tific oculist  of  this  city,  informs  me  that  this  is  the 
case  with  Stramonium  ;  and  that,  on  the  other  hand, 
the  Belladonna  of  Europe  is  more  powerful,  in  dilat- 
ing the  pupil,  than  the  exotic  Belladonna  of  America. 
Again,  if  the  shrub  Rhus  tox.  is  a  stunted  variety  of 
the  same  species  as  the  vine  Rhus-rad.,  there  is  an 
additional  reason  for  doubting  whether  it  has  as  much 
activity ;  furthermore,  the  provings  afford  evidence 
that  it  has  not.  So  far  as  the  clinical  experience  of 
many  physicians  for  some  years  can  show,  the  Rhus- 
rad.  is  as  efficacious  as  Rhus-tox.  or  more  so,  in  those 
cases  to  which  the  latter  is  applicable.  Like  several 
other  physicians,  I  prefer  it.  Wherever  in  the  re- 
pertory, the  generic  term  Rhus  is  used  alone,  it  may 
be  considered  as  including  both  Rhus-rad.  and  Rhus- 
tox. 

men-Codex,  is  grossly  incorrect,  especially  where  it  attempts  to  cor- 
rect my  botanical  description  of  this  plant  in  general,  and  of  the 
particular  plant  from  which  I  obtained  the  specimen  for  trial.  This 
last  part  of  the  criticism  is  not  only  incorrect,  but  absurd ;  inasmuch 
as  the  botanical  character  of  those  particular  leaves  could  be  known 
only  to  myself  and  my  respectable  medical  colleagues  who  engaged 
with  me  in  the  provings,  and  to  whom  the  leaves  were  shown.  I 
here  re-affirm  the  correctness  of  my  description,  as  given  in  the  Note 
in  the  body  of  the  same  Symptomen-Codex,  pages  671  and  673. 
7 


134  CASES    OP  CHOLERA 


If  great  debility  follows  the  Cholera,  and  there  are 
no  other  symptoms  which  require  special  attention, 
the  appropriate  remedy  is  Cinchona  12.  The  final 
remedy  for  the  more  complete  restoration  of  health, 
will  frequently  be  Sulph.  80,  given  in  a  single  dose, 
and  allowed  to  act  a  long  time  without  repetition. 

When  a  homoeopathic  physician  is  called  in  any 
stage,  to  any  case  of  Cholera  which  has  been  under 
allopathic  treatment,  he  is  first  to  antidote  the  for- 
mer treatment  by  Camphor.  Give  it  but  a  short 
time,  if  there  is  any  inflammation.  He  can  judge  if 
other  antidotes  are  necessary  ;  as  they  frequently  will 
be  in  the  course  of  the  treatment ;  for  calomel  and 
crude  drugs — and  even  the  undiluted  colored  tinc- 
tures of  the  homoeopathic  shops — are  so  durable  in 
their  mischievous  action,  as  to  require  for  their  cor- 
rection, something  more  durable  in  its  curative  ac- 
tion, than  Camphor. 


CHAPTER  IX. 
CASES  OF  CHOLERA  IN  NEW-YORK, 

IN     1849     AND     SUBSEQUENT     YEARS WITH 

A    FEW    EXAMPLES    OF    CHOLEROID    DISEASE. 


PRELIMINARY    REMARKS. 

The  following  cases  are  given  as  examples  of  the 
symptoms  and  treatment  of  several  forms  of  the  dis- 


IN    NEW-YORK.  135 


ease.  To  give  them  value  for  statistical  use,  a  report 
of  the  entire  number  of  cases  would  be  requisite. 

The  author  regrets,  that  the  engrossing  nature  of 
his  practice  in  the  epidemic,  left  him  too  little  time  to 
give  as  full  description  even  of  the  cases  here  pub- 
lished, as  would  be  desirable.  The  records  of  most 
of  his  other  cases  are  meagre.  Some  of  those  here 
given  •will  be  of  use  to  the  student  and  practitioner ; 
they  perhaps  occupy  sufficient  space  in  the  book  for 
most  practical  purposes.  The  patients  were  persons 
of  intelligence,  and  their  statements  reliable.  All 
the  cases  except  the  5th,  14th,  loth,  18th,  and  19th, 
occurred  when  the  Cholera  was  extensively  prevalent. 
Some  may  be  disposed  to  call  the  rarer  cases  sporadic. 
Sporadic  means  scattered,  and  is  properly  and  gene- 
rally applied  to  cases  of  disease  which  are  not  only 
scattering,  but  independent  of  a*ny  epidemic  or  con- 
tagious influence. 

When  cases  occur  at  long  intervals,  are  few  and 
isolated,  some  persons  doubt  whether  they  are  Asia- 
tic Cholera,  however  characteristic  the  symptoms — 
because,  say  the  sceptics.  Cholera,  when  it  exists,  is 
an  epidemic,  i.  e.,  a  prevalent  disease.  But  an  epi- 
demic must  have  a  beginning  and  termination,  in  sin- 
gle cases ;  and  subsequent  to  the  first,  and  antece- 
dent to  the  last,  are  rare  cases.  By  cutting  off  both 
ends  of  the  pestilence,  pronouncing  them  sporadic, 
and  thus  putting  them  in  another  category,  some 
prove  to  their  own  satisfaction,  from  experience,  that 
Cholera  when  it  actually  exists,  is  a  prevalent  disease. 


136  CASES    OF  CHOLERA 

The  next  step  is  to  apply  this  inference  in  justifying 
the  subsequent  exclusion  of  rare  and  isolated  cases. 
This  is  reasoning  in  a  circle. 

The  term  epidemic  may  be  properly  employed, 
either  with  reference  to  the  general  prevalence  of  the 
atmospheric,  or  other  invisible  cause,  or  to  the  gene- 
ral prevalence  of  the  resulting  disease.  The  cause 
is  epidemic  (epidemos,  upon  the  people,)  earlier  than 
the  disease ;  and,  after  its  introduction,  it,  or  some 
impression  made  by  it,  may  exist  for  years,  but  in 
such  a  state  as  to  produce  only  a  few  cases.  At  dif- 
ferent times  since  1849,  I  have  seen  cases  here,  which 
resembled  Cholera  more  strongly  than  any  which 
had  fallen  under  my  observation  for  many  preceding 
years. 

Such  considerations  are  calculated  to  allay  rather 
than  excite,  undue  apprehension  in  the  public  mind, 
at  times  when  composure  is  most  needful.  The  idea 
that  a  new  poison  is  just  now  imported,  is  more 
dreadful  than  that  of  an  addition  to  one  previously 
present.  If  medical  men  and  municipal  officers  con- 
ceal the  scattering  cases,  and  suddenly  announce  the 
arrival  of  the  pestilence  after  it  has  gained  a  more 
formidable  strength,  the  public  mind  not  only  receives 
a  severe  shock,  but  at  a  time  when  more  than  at  any 
other,  such  excitement  is  dangerous.  Besides,  such 
concealment  at  the  earliest  and  last  stages  of  the  epi- 
demic, tends  to  prevent  the  adoption  of  necessary 
precautions  by  individuals.  I  have  known  of  fatal 


IN    NEW-YORK.  137 


cases  which  would  have  been  prevented,  by  informa- 
tion of  the  existence  of  Cholera  in  the  city.* 

The  valuable  cases  which  Drs.  Bayard,  Quin,  and 
Wright,  have  reported  to  the  author,  are  described  in 
the  well-selected  language  of  those  learned  and  expe- 
rienced  physicians. 

The  following  cases  occurred  in  the  practice  of  the 
author,  with  the  exception  of  those  in  which  the  name 
of  some  other  physician  is  mentioned  in  connection 
with  the  case.  Those  which  bore  some  resemblance 
to  Cholera,  but  wanted  a  sufficient  number  or  severity 
of  the  characteristic  symptoms,  may  be  termed  Cho- 
leroid.  It  is  not  considered  necessary  to  give  many 
of  these,  although  in  the  author's  practice,  they  were 
about  eight  times  as  numerous  as  the  cases  reported 
as  Cholera. 

Where  Camphor  was  employed  in  Cholera,  it  was 
always,  unless  otherwise  stated,  given  in  drop-doses, 
in  solution  in  sugared  water,  prepared  according  to 

*  Epidemics  seem  to  depend  in  some  instances,  at  least  in  part, 
upon  some  cause  which  increases  the  predisposition.  On  this  prin- 
ciple, I  explain  the  fact,  that  the:  susceptibility  to  vaccination  is 
greater  when  small-pox  is  most  prevalent.  The  latter  has  at  least 
been  the  case  in  this  city,  during  the  epidemic  small-pox  of  the  win- 
ter of  1853-4,  as  compared  with  years  when  the  latter  disease  was 
far  less  prevalent.  Of  the  142  vaccinations  performed  by  me  in  pri- 
vate practice,  from  November  to  March  inclusive,  more  than  half 
were  successful,  and  some  in  persons  who  had  previously  had  small- 
pox, some  varioloid,  and  one  in  a  lady  who  had  had  both  very  deci- 
dedly, she  now  took  vaccination  in  an  equally  decided  degree.  Near- 
ly all  the  subjects  had  been  previously  vaccinated  once  or  more. 


138  CASE8    OF  CHOLERA 


the  method  described  in  this  hook.  In  regard  to  other 
medicines,  where  only  a  single  dose  of  any  attenua- 
tion was  administered,  it  was  about  three  small  glo-. 
bules  placed  dry  on  the  tongue,  by  itself,  or  in  suirar 
or  saccharum-lactis.  Where  a  greater  number  of  do- 
ses of  an^  attenuated  medicine  were  employed,  the 
method  was  to  dissolve  about  six  small  globules  in  a 
gill,  i.  e.,  half  a  tumblerful  of  cold  water,  and  di- 
rect the  patient  to  take  three  teaspoonfuls  at  a  time, 
as  a  dose. 

The  professional  reader  will  understand  the  charac- 
ter 3  to  signify  prescription,  or  treatment  prescribed 
or  commenced  by  the  physician.  When  a  figure  is 
prefixed  to  the  name  of  the  medicine,  it  signifies  the 
number  of  doses.  The  figure  at  the  right  of  the 
name  of  the  medicine,  and  a  little  above,  denotes  the 
attenuation  or  potency. 


CASES    OF    CHOLEROID    DISEASE. 

-CASE  1. — Diarrh&ic  Choleroid. —  On  Tuesday, 
July  10th,  1849,  an  unmarried  gentleman,  a  mer- 
chant, aged  about  24,  applied  to  me  on  account  of  a 
simple  diarrhoea,  and  received  three  powders  of  Cam- 
phor3, to  be  taken  dry,  and  a  powder  of  Veratrum80, 
to  be  taken  in  solution,  in  seven  doses.  lie  was  for 
the  time  relieved  :  but  in  the  latter  part  of  the  follow- 
ing day,  Wednesday,  he  used  some  indigestible  food 


IN    NEW-YORK.  139 


in  improper  quantity.  In  the  succeeding  night, 
Thursday,  2  A.  M.,  he  was  suddenly  attacked  with 
diarrhoea  of  a  different  character.  In  this  last  attack 
the  stools  were  at  first  thin  and  brown,  afterwards 
watery  and  white.  Veratrum  30,  after  each  evacua- 
tion, relieved  him  permanently. 

Remark. — The  suddenness  of  the  attack,  the  noc- 
turnal invasion,  and  the  watery  consistence  and  milky 
color  of  the  evacuations,  are  among  the  characteris- 
tics of  Cholera.  But  others  were  wanting.  The 
patient  was  not  prostrated,  but  able  to  call  at  my  of- 
fice. This  may  be  considered  as  a  case  of  Cholerine, 
i.  e.,  Diarrhceic  Choleroid. 


CASE  2. — Spasmodic  Choleroid. — On  Sunday 
morning,  August  19th,  1849,  a  merchant,  aged  37 
years,  had  a  loose  evacuation.  Without  consulting  a 
physician,  he  took  Veratrum.  From  his  medical 
associations,  I  had  little  doubt  that  it  was  some  low 
dilution. 

At  midnight,  he  was  seized  with  a  chill,  or  parox- 
ysm of  shivering,  soon  attended  with  cramps  in  the 
jaw  and  wrists.  Being  alarmed  at  these  symptoms, 
he  sent  a  carriage  for  me  as  soon  as  possible.  The 
distance  was  about  a  mile.  In  the  mean  time,  he 
took  tincture  of  Camphor,  which  on  my  arrival  at  a 
quarter  before  two,  A.  M.,  had  been  followed  by  per- 
spiration. 


140  CASES    OF    ril.U, Kit-Mi) 


Prescription,  Cuprum  3U.  He  was  well  the  same 
day,  Monday,  20th. 

Remarks. — This  may  be  considered  as  a  case  of 
spasmodic  choleroid ;  or  in  other  words,  spasmodic 
cholera  arrested  in  the  first  stage.  It  sustained  the 
same  relation  to  developed  spasmodic  cholera,  that 
cholerine  does  to  developed  diarrhoeic  cholera. 

That  the  cholera  poison  had  some  agency  in  the 
production  of  this  gentleman's  symptoms,  I  subse- 
quently had  additional  evidence,  in  being  called  on 
the  same  day,  the  20th,  to  visit  two  of  his  children, 
attacked  with  diarrhoeic  cholera ;  many  liquid  and 
ricey  evacuations,  some  of  them  copious.  One  at 
least  had  a  decidedly  cold  tongue.  The  symptoms 
had  commenced  on  the  same  day  as  the  premonitory 
looseness  of  the  father,  but  not  with  severity  suffi- 
cient to  excite  apprehension  in  the  family,  and  induce 
them  to  seek  medical  aid. 

In  such  epidemics,  several  nearly  simultaneous  at- 
tacks in  a  family  are  not  uncommon. 

In  the  epidemic,  there  were  many  instances  of 
slight  spasmodic  choleroid.  Thus  the  cholera  poison 
manifested  its  influence  by  exciting  frequently  re- 
peated cramps  in  individuals,  for  several  weeks  before 
they  were  attacked  with  cholera.  Such  cases  show 
an  early  impression  on  the  nervous  system.  That 
this  impression  may  be  instrumental  in  changing  the 
blood,  and  be  one  of  the  earliest  links  in  the  chain, 
I  long  since  recognized  in  an  article  which  was  pub- 


IN    NEW-YORK.  14 


lished  in  the  Transactions  of  the  Medical  Society  of 
the  State  of  New  York,  and  from  which  I  have  ex- 
tracted most  of  the  first  two  chapters  of  this  book. 
It  was  not  thought  necessary  to  extract  these  more 
hypothetical  parts  on  pathogeny,  and  they  are  refer- 
red to  now  to  show,  that  the  nervous  theory  of  chole- 
ra is  neither  new  nor  incompatible  with  that.given  in 
this  book. 

In  some  instances,  the  change  of  color  of  the  blood 
in  certain  parts,  was  the  most  marked  of  the  early 
symptoms,  and  almost  the  only  one  One  of  the  ca- 
ses of  this  kind  of  dry  choleroid,  which  came  under 
my  observation,  is  described  in  the  appendix.  It  oc- 
curred in  a  young  gentleman,  at  that  time  laboriously 
engaged  in  practising  in  the  epidemic.  He  was  ex- 
posed to  many  of  the  most  malignant  cases,  and  in 
the  most  unhealthy  localities.  The  bluish-black  color 
of  his  fingers,  which  he  describes,  I  saw  several 
times. 


CASE  3. — Diarrhoeic  Choleroid. — On  Tuesday, 
Sept.  25th,  1849,  at  8£-.  A.  M.,  Capt.  C.  called  on 
me  to  visit  his  wife  immediately.  Aged  about  27 ; 
had  slight  diarrhoea  last  evening.  This  morning 
was  suddenly  attacked  with  nausea,  violent  diarrhoea 
and  severe  pains  in  the  abdomen.  There  were  three 
stools,  brown  and  "watery" — two  of  them  large. 

5 — 3  Veratrum  30,  one  every  hour;  afterwards, 
7* 


142  CASES    OF    CHOLEROID 

only  once  in  three  hours,  unless  there  should  be  eva- 
cuations. 

Called  in  the  evening,  and  found  that  she  had  im- 
mediately recovered  under  the  Veratrum  80. 

CASE  4. — M.,  a  girl  aged  10.  Attacked  witlj  vio- 
lent diarrhoea  and  colic,  in  the  night,  between  two 
and  three,  A.  M.,  Friday,  Sept.  28th,  1849.  1  was 
sent  for  at  seven,  and  arrived  at  seven  and  a  half, 
A.  M.  Five  stools,  the  first  three  about  a  pint  each, 
watery,  with  pea- sized  pieces  of  something  yellowish. 

3 — 1  Arsenicum  80,  dry,  then  Veratrum  30,  in  so- 
lution, each  hour  till  relieved ;  then  once  in  two 
hours.  Recovery  on  the  same  day  under  the  Vera- 
trum 30. 


CASE  5. —  Gastro-enteric  Choleroid. — On  Thurs- 
day, July  21st,  1853,  at  nine,  A.  M.,  B.  F.  Joslin,  Jr., 
M.D.,  was  called  to  visit  a  boy,  aet.  seven  years,  who 
had  vomiting  and  diarrhoea.  Had  been  attacked 
about  four,  A.  M.  The  discharges  frequent,  extreme- 
ly so  at  first ;  most  of  them  yellowish  and  watery, 
the  last  colorless,  having  the  appearance  of  clear 
water.  Rice-water  vomiting ;  pulse  138 ;  tongue 
whitish  and  cool ;  lips  cold.  Three  hours  after- 
wards, at  twelve  o'clock,  I  visited  the  patient  in 
consultation.  There  was  no  vomiting  nor  diarrhcaa. 
Some  degree  of  reaction  had  taken  place.  Ar- 
senicum io  continued.  At  half  past  four,  P.  M., 


IN    NEW-YORK. 


143 


Dr.  Joslin,  Jr.,  made  his  third  visit.  Pulse,  120 
and  full ;  lips  warm  ;  tongue  warm. 

?.  Aconitum  30,  alternately  with  Arsenicum  30. 
On  the  next  day,  the  boy  was  found  cured.  Treat- 
ment discontinued. 

Remark. — This  case  approximated  very  nearly  to 
developed  Cholera,  but  was  not  reported. 


CASE  6. — Dry  Choleroid. — In  the  epidemic  of 
1849,  Dr.  B.,  aged  42,  was  suddenly  awakened  in  the 
night  with  a  sensation  of  great  coldness.  At  first  he 
supposed  that  the  wind  was  blowing  upon  him.  His 
wife  remarked,  "you  are  covered  with  a  profuse,  cold 
sweat."  The  Doctor  then,  on  examination,  perceived 
that  the  sweat  was  general,  cold  and  clammy.  Great 
weakness,  with  a  degree  of  restlessness.  Mrs.  B., 
asked  the  Doctor  what  medicine  he  would  take.  He 
replied  the  third  of  Camphor.  His  wife  fearing  this 
was  not  sufficiently  powerful,  endeavored  to  persuade 
him  to  take  the  tincture  in  drop  doses.  But  the  Doc- 
tor, supposing  he  had  Cholera-sicca,  and  having  rea- 
sons to  believe  in  the  power  of  attenuated  Camphor, 
when  properly  indicated,  determined  to  try  it  on  his 
own  person,  and  accordingly  took  a  few  pellets  of  the 
third  dilution,  i.  e.  Camph.  3,  dry,  on  the  tongue,  and 
after  waiting  fifteen  minutes,  repeated  the  dose.  A 
short  time  after  this,  he  was  conscious  of  an  increased 


144  CASES    OF    CHOLEROID 


•warmth,  a  drying  up  of  the  sweat,  which  rapidly  took 
place,  and  a  calmness  of  feeling,  which  predisposed 
to  sleep.  He  awoke  in  the  morning  with  his  usual 
amount  of  health. 

Remark. — This  case  is  placed  in  the  Choleroid 
class,  not  because  there  is  any  doubt  respecting  its 
cause  or  tendency,  but  because  the  disease  was  ar- 
rested in  the  first  stage.  Yet  the  most  marked 
symptom  which  was  present,  belongs  oftener  to  the 
third  stage  of  Cholera  of  other  varieties.  The  first 
stage  of  Cholera-sicca,  may  be  as  dangerous  as  the 
second  or  third  of  some  other  varieties. 


CASES  OF  DIARRHCEIC  CHOLERA. 
CASE  7.— On  Monday,  June  4th,  1849.— Mr.  S., 
a  mechanic,  aged  forty,  residing  in  the  upper  part  of 
the  city,  dined  later  than  usual,  on  stewed  kidneys, 
of  which  he  made  his  meal.  The  night  following, 
he  was  disturbed  several  times  in  his  sleep  by  a 
diarrhoea,  with  colic  before  evacuation.  The  next 
day,  June  5th,  it  increased  ;  and  on  the  morning  fol- 
lowing, June  6th,  feeling  more  unwell,  he  sent  for  Ed- 
ward Bayard,  M.  D.  He  found  the  patient  vomiting 
and  purging;  profuse  watery  discharges  without 
smell  or  color  ;  cold  sweat  over  the  body,  more  parti- 
cularly on  the  forehead ;  skin  shriveled  and  blue  ; 
tongue  and  breath  cold  ;  pulse  scarcely  perceptible  at 
the  wrist ;  throwing  his  arms  about  with  exc.essive 
restlessness  ;  complaining  of  cramps  in  the  region  of 
the  stomach  and  in  the  calves  of  his  legs  ;  voice 


IN    NEW-YORK. 


145 


sepulchral.  Dr.  Bayard  gave  him  a  drop  of  the  tinc- 
ture of  Camphor  in  a  tablespoonful  of  water,  every 
fifteen  minutes  for  three  times,  which  produced  no 
visible  effect.  He  then  dissolved  a  few  pellets  of  the 
thirtieth  dynamization  of  Veratrum  in  a  tumbler  one 
third  full  of  water,  and  gave  a  tablespoonful  of  the 
mixture,  and  in  thirty  minutes  repeated  the  remedy. 
The  pulse  rose,  and  likewise  the  temperature  of  the 
body.  On  the  third  dose,  the  vomiting  became 
frothy,  indicative  of  the  action  of  the  medicine.  The 
remedy  was  then  discontinued.  In  a  short .  time, 
reaction  fully  set  in,  and  in  a  few  days,  the  patient 
was  entirely  restored  to  health. 

CASE  8.— On  Monday,  June  25th,  1849.— A  mar- 
ried gentleman,  a  merchant,  aged  about  30,  was  at- 
tacked in  the  night,  about  two,  A.  M.,  with  violent 
watery  diarrhoea.  When  first  visited  in  haste,  early 
in  the  morning,  he  had  had  several  evacuations,  at- 
tended with  cold  perspiration  on  the  face.  Decidedly 
dark  and  unnatural  color  of  the  face.  Great  prostra- 
tion, was  unable  to  step  without  assistance.  Cramps 
in  the  abdomen.  The  watery  evacuations  still  con- 
tinued. He  was  treated  by  Camph.  ^  in  drop  doses, 
in  sugared  water,  and  Camph.  3  in  solution.  The 
diarrhoea  immediately  stopped  under  the  Camphor  ; 
but  Veratrum  io,  in  solution,  was  given  in  the  even- 
ing and  next  day.  During  his  convalescence  on  this 
second  day,  he  also  took  one  Belladonna  30,  and  one 
Nux-vom.  100°,  and  finally,  on  the  third  day,  one 
Nux-vom.  30  all  dry. 


146  CASES  OF  CHOLERA 

CASE  9.— Friday,  June  29th,  1849.— A  married 
lady,  aged  about  35,  had  a  sudden  attack  of  diarrhoea 
three  days  since.  She  took  Camphor  tincture,  in  one 
drop  doses,  and  being  relieved,  did  not  think  it  ne- 
cessary to  send  for  a  physician.  Yesterday  walked 
much.  This  morning  at  six  o'clock,  was  attacked 
•with  diarrhoea  and  colic. 

I  saw  her  at  eleven,  A.  M.  The  diarrhoea  con- 
,  tinued  up  to  that  time.  In  the  five  hours,  she  has  had 
twelve  stools,  I  saw  the  last,  which  consisted  of  about 
three  gills  of  rice-water  liquid,  with  abundant  white 
ricey  flocks.  Coat  on  the  tongue  whitish  with  a  scarce- 
ly perceptible  tinge  of  yellow.  Urine  suppressed. 

3.  Phosphorus  30,  one  dose  dry,  the  others  in 
solution. 

Saw  her  again  about  four,  P.  M.  She  had  in  one 
hour  considerable  cramp  in  the  abdomen,  between 
the  umbilicus  and  right  groin ;  is  now  free  from  it. 
Has  taken  the  Phos.  3  °  every  second  hour,  i.  e.  three 
times  in  all.  No  stool  since  commencing  it.  Is 
much  better.  Has  had  one  moderate  discharge  of 
urine.  Is  to  take  a  few  more  doses  of  Phos.  305  solut. 
at  intervals  of  two  hours. 

Was  seen  on  the  next  day,  but  required  no  repeti- 
tion of  the  medicine. 

Sunday,  the  third  day.  Took  one  China  30,  for  the 
remaining  debility. 

Tuesday,  the  fifth  Jay.  Convalescent.  Took  one 
Sulphur  80. 


IN    NEW-YORK.  147 


CASE  10.— Tuesday,  July  3d,  1849.— Mrs.  C., 
aged  about  32,  had  had  more  than  forty  stools  in 
thirty-six  hours.  Had  taken  of  her  own  accord,  six 
one-drop  doses  of  Camphor,  and  twelve  more  this 
evening  at  intervals  of  five  minutes.  At  eleven  and 
a  quarter,  P.  M.,  I  was  called  in  great  haste,  and  at 
eleven  and  a  half  found  her.  Nausea,  with  much 
effort  avoided  vomiting.  The  diarrhoea  continued ; 
the  stools  liquid.  Pain  and  tenderness  of  the  ab- 
domen, in  which  were  rumblings  of  gas  and  sound  of 
running  liquid.  She  had  suffered  much  pain  there 
on  both  days.  The  noises  in  the  abdomen  had  com- 
menced at  the  midnight  preceding  the  attack,  and 
after  unusual  fatigue  on  the  preceding  day.  Feet 
cold  ;  hands  cool.  Transient  chilliness"  alternating 
with  heat.  She  has  felt  unusually  cold  this  season. 

Prescription. — One  Verat. 12  dry,  then  Verat.80 
in  solution,  a  dose  after  each  evacuation. 

The  nausea  was  for  a  few  minutes  increased  after 
the  Veratrum  12.  Normal  warmth  returned  to  the 
feet  soon  after  its  administration. 

Wednesday,  llf  A.  M.,  the  third  day  of  the  dis- 
ease, and  the  second  of  my  treatment. 

After  one  dose  of  Verat.  12,  there  has  been  no 
stool  till  this  morning,  when  there  were  two,  but  of 
a  very  different  character  from  the  former,  i.  e.  not 
liquid,  but  merely  soft.  Tenderness  of  abdomen 
much  relieved — now  but  slight.  Feet  cold.  The 
patient  feels  greatly  prostrated — requires  the  recum- 
bent posture. 


148  CASES  OF  CHOLERA 

Ordered  beef  broth,  and  solution  of  Veratrum  80, 
pro  re  nata,  as  before. 

On  the  following  day,  the  patient  was  convales- 
cent. Verat.  30  was  once  more  prescribed,  and  the 
recovery  was  completed  under  its  action. 

CASE  11.— Thursday,  July  5th,  1849.— An  un- 
married lady,  aged  about  25,  had  between  midnight 
and  noon,  when  I  saw  her,  twelve,  or  more,  liquid 
stools,  varying  in  quantity  from  a  pint  to  a  quart 
each  ;  the  first  brownish.  Those  in  the  morning  had 
the  rice-water  character.  She  described  them  as 
containing  numerous  small  white  pieces,  like  the 
curds  of  milk  that  sometimes  pass  an  infant's  bowels. 
Her  extremities  were  cold  in  the  night ;  and  there 
were  cramps  in  the  calves  of  the  legs.  She  took  ten 
doses  of  Camphor,  one  drop  each. 
Her  pulse  is  now  weak  and  slow. 
Prescription. — Verat.  30  in  solution,  once  in  two 
hours. 

Six,  P.  M.  Much  better.  No  evacuations  since 
commencing  the  Veratrum. 

Friday,  the  second  day.  The  patient  is  weak. 
Prescription:  China  24,  twice  a  day,  three  doses. 

On  the  fourth  and  fifth  day  [of  the  disease,  she 
again  took  V  eratrum  3  °  in  solution.  The  recovery 
was  completed  without  any  farther  prescription. 

Remarks.  The  cure  seems  to  have  been  princi- 
pally effected  by  Camph.  TV  and  Veratrum  30.  The 
effect  of  China  is  not  stated  in  the  record.  Debili- 
ty, when  caused  by  profuse  evacuations,  as  it 


IN    NEW-YORK.  149 


seemed   to   be  in   part    in  this  case,  is  one  of  the 
indications  for  its  use. 

CASE  12. — A  married  lady,  aged  34,  was  attacked 
on  Thursday,  Aug.  23d,  1849,  in  the  morning,  but 
not  visited  till  next  day  at  half  past  five,  P.  M., 
when  she  had  had  thirty  alvine  evacuations.  The  ag- 
gregate measure  of  the  stools  was  about  three  gal- 
lons. In  consistence  and  color  many,  if  not  most 
of  them,  resembled  milky  water  or  rice-water.  The 
patient  had  but  little  pain,  and  no  apprehension  of 
danger,  but  expressed  merely  her  astonishment, 
that  the  contents  of  the  bowels  should  pass  from  her 
"  like  a  flood."  The  pulse  was  extremely  feeble,  and 
the  tongue  cold. 

The  Cholera  prevailed  much  in  the  immediate 
neighborhood,  and  many  deaths  had  just  occurred 
there. 

Now  commenced  Veratrum  30  in  solution,  to  be  re- 
peated every  hour.  My  son,  B.  F.  J.,  Jr.,  saw  her  in 
the  evening,  and  continued  the  Verat.  30. 

Saturday,  the  third  day.  At  half  past  ten  o'clock, 
last  night,  the  patient  had  a  rice  water  and  ricey 
stool,  measuring  two  quarts.  The  next  evacuation 
occurred  at  one,  A.  M.,  and  showed,  by  the  quantity 
and  color,  a  decided  improvement,  the  stool  measured 
but  one  pint,  and  was  yellowish.  Since  that  there  has 
been  none.  The  tongue  is  warm.  Prescribed  Ve- 
ratrum 30,  in  solution,  once  in  two  hours. 

On  Sunday,  the  fourth  day,  the  patient  was  found 
convalescent,  but  the  Verat.  3  °  was  given  again  that 


150  CASES  OF  CHOLERA 

day.  She  recovered  without  the  use  of  any  other 
medicine,  in  any  stage  of  the  treatment. 

Remarks. — The  total  amount  of  the  evacuations 
was  nearly  four  gallons.  I  saw  no  fatal  case,  in 
which  there  was  good  evidence  of  as  great  a  quan- 
tity of  liquid  being  discharged,  as  in  this.  The  more 
important  changes  in  the  blood  seem  to  be  more  de- 
pendent upon  the  impression  made  by  the  poison  on 
the  nervous  system,  than  upon  the  loss  of  its  more 
liquid  portions  consequent  upon  evacuations ;  though 
in  many  constitutions,  a  copious  discharge,  as  com- 
pared with  a  moderate  one,  will,  c&teris  paribus,  re- 
sult from  a  stronger  impression.  But  in  the  severest 
asphyxia!  cases,  the  impression  is  too  strong  to  ad- 
mit of  much  if  any  evacuation. 

CASE  13.— On  Sunday,  Sept.  16th,  1849,  the 
owner  and  superintendent  of  a  manufacturing  esta- 
blishment, aged  34,  had  a  loose  evacuation  in  the 
morning.  In  the  course  of  the  day  was  somewhat 
thirsty.  I  saw  him  and  prescribed  Veratrum  30. 
About  ten  o'clock  in  the  evening,  he  had  a  sudden 
and  loose  movement  of  the  bowels,  preceded  by  a  sense 
of  oppression  at  the  stomach.  Afterwards  in  the 
nif'ht  there  were  five  brown  and  liquid  stools,  each 
measuring  about  a  pint  and  a  half.  The  desire  to 
evacuate  was  urgent  and  irresistible ;  and  the  eva- 
cuations attended  with  rumblings  and  nausea.  Pain 
and  tenderness  in  the  stomach,  but  none  in  the  ab- 
domen. No  sleep  in  the  night. 

Monday,  the  second  day,  at  noon. 


IN    NEW-YORK.  151 


Urine  has  been  almost  or  quite  suppressed.  The 
patient  passed  about  a  gill  and  a  half,  after  eight 
and  a  half  hours.  Prostrated — keeps  his  bed.  The 
nausea,  tenderness  of  the  stomach,  and  diarrhoea  con- 
tinue. The  last  two  stools  were  examined  and  found 
to  be  quite  watery.  The  evacuations  excited  by  any 
movement  of  the  body. 

Treatment. — Phosphoric-acid  3  °  given  in  solution, 
every  third  hour. 

Tuesday,  the  third  day. 

Convalescent.  No  stool  after  commencing  the 
Phosphoric-acid  30.  Tongue  warm ;  red  at  the  tip. 
Medicine  was  then  discontinued. 

Wednesday,  the  fourth  day. 

Relapse. — The  patient  had  gone  out  prematurely, 
had  eaten  a  peach,  a  potato,  and  soup  containing  to- 
matos  and  other  vegetables.  Had  had  some  nausea 
on  this  and  the  day  previous,  but  had  not  considered 
it  worth  mentioning.  At  ten  o'clock  this  evening,  a 
profuse  diarrhoea  commenced  suddenly  ;  had  four 
evacuations,  above  two  quarts  in  all,  in  an  hour  and 
a  quarter.  Sent  immediately  for  medical  aid.  I 
I  saw  him  at  eleven,  P.  M.,  and  examined  the  stools ; 
they  were  liquid  and  brown.  Nausea.  Anterior 
part  of  nose  cold.  Tongue  not  cold;  neither  were 
the  feet.  Pulse  slow,  54.  Prescribed  Veratrum  30, 
one  dose  dry  ;  this  was  repeated  in  solution,  after 
the  next  evacuation,  which  occurred  in  about  half  an 


152  CASES  OF  CHOLERA. 


hour  after  the  preceding.  About  the  same  time 
had  a  sensation  of  general  chilliness. 

Quarter  hefore  twelve,  P.  M. 

Tongue  perfectly  cold  at  the  anterior  part ;  nose 
still  cold ;  restlessness.  Pain  at  upper  part  of 
stomach,  since  this  last  attack.  Prescribed  one 
dose  of  Arsenicum  80,  at  this  time,  quarter  before 
twelve  o'clock. 

Quarter  past  twelve  o'clock,  at  night. 

No  evacuation  since  the  second  dose  of  Verat.  *°. 
Tongue  became  warm,  half  an  hour  after  the  first 
dose  of  Arsenicum  ?°.  The  patient  was  then  left, 
with  directions  to  take  Veratrum  80  and  Arsenicum 
8  °,  alternately  after  each  evacuation,  or  in  any  case 
at  intervals  of  one  and  a  half  hours,  if  awake. 
Should  there  be  extensive  coldness  of  the  body, 
Carbo.-veg.  30,  was  to  be  administered. 

Thursday,  the  fifth  day. 

Eleven,  A.  M.  One  copious  stool  in  the  night, 
and  one  this  morning :  they  were  like  the  preceding 
ones  in  color  and  quantity,  but  still  thinner — quite 
watery.  Has  taken  the  Verat.  80  and  Arsen.  30, 
alternately.  Tongue  warm ;  slight  tenderness1  of  the 
stomach  and  abdomen ;  movement  in  the  abdomen, 
sounding  like  the  trickling  of  a  liquid ;  pains  in  the 
temples,  sharp  but  not  shooting.  Prescribed  Vera- 
trum 3"  in  solution. — The  patient  recovered  under 
this  medicine. 

Remark. — Relapses  during  convalescence  are  to 


IN    NEW-YORK. 


153 


be  carefully  guarded  against,  by  avoiding  errors  of 
diet  and  undue  exertion. 

CASE  14.— In  1854,  on  Sunday,  May  7th,  at 
three,  P.  M.,  Clark  Wright,  tyl.  D.,  was  called  to 
visit  a  merchant  of  this  city,  who  was  suffering 
under  Cholera,  having  been  attacked  in  the  previous 
night,  at  two,  A.  M.  The  family  and  patient  gave 
the  following  description  of  the  case. 

He  was  suddenly  attacked  with  diarrhoea ;  the 
stools  liquid  and  profuse.  The  evacuations  con- 
tinued at  intervals,  up  to  the  time  of  the  first  visit. 
The  patient  expressed  his  astonishment  at  the  quan- 
tity, wondering  "where  so  much  could  come  from." 

At  three,  P.  M.,  Dr.  W.  found  the  pulse  very 
feeble ;  extremities  cold  ;  cramps  in  the  calves  and 
thighs  ;  skin  of  the  hands  inelastic,,  and  that  of  the 
fingers  corrugated ;  an  unnatural,  hoarse,  and  hollow 
voice ;  bluish  tinge  of  the  face,  and  dark  color  under 
the  eyes. 

Soon  after  this,  there  was  another  evacuation. 
The  stool  on  examination,  was  found  to  be  serous 
with  whitish  flocks.  Urine  extremely  scanty.  There 
had  been  no  treatment. 

There  was  now  prepared  a  solution  of  Camphor, 
made  by  dropping  six  drops  of  the  tincture  on  a 
lump  of  sugar,  and  dissolving  this  in  two-thirds  of  a 
tumblerful  of  water.  Dose,  a  table-spoonful,  once  in 
from  five  to  ten  minutes,  for  an  hour.  Then, 
when  there  began  to  be  more  warmth  in  the  ex- 


154  CASES    OF    CHOLERA 


tremities,  and  some  improvement  in  the  pulse,  the 
Camphor  was  discontinued,  and  a  dose  of  Veratrum  * 
given. 

About  an  hour  afterwards,  there  was  an  evacua- 
tion, like  dirty  rice-water,  followed  by  extreme  pros- 
tration and  thirst ;  also,  nausea  and  sensation  of 
sinking  at  the  stomach ;  and  profuse  and  cool  per- 
spiration. Drowsiness,  with  eyes  half  closed  and 
eye-balls  upturned. 

Ice  was  then  given,  ad  libitum,  and  Camphor  re- 
sumed in  the  same  doses  as  before,  i.  e.  half  a  drop 
each,  and  given  every  five  minutes,  for  half  an  hour, 
when  the  perspiration  became  warm.  It  soon  after- 
wards dried  up,  leaving  the  skin  warm.  Camphor 
then  stopped.  Veratrum  %  and  Phos.-acid  12,  then 
given  alternately,  every  half  hour.  Two  doses  of 
each  were  taken. 

The  patient  then  fell  into  a  sweet  sleep,  slept  for 
half  an  hour,  and  awoke  refreshed.  Had  another  but 
smaller  passage,  slightly,  tinged  with  yellow,  after- 
wards another  of  a  deeper  yellow. 

After  waiting  two  hours,  there  being  no  stool,  and 
all  other  symptoms  improving,  Dr.  Wright  made  the 
following  prescription  for  the  night :  Verat.  6  and 
Phosphorus  6  alternately,  one  after  every  stool. 

Monday,  second  day,  in  the  morning.  Had  had 
only  two  stools  and  taken  two  doses.  The  last, 
which  had  been  saved,  had  a  foecal  odor. 

In  the  course  of  the  day,  had  three  stools  of  more 
consistence,  and  a  more  natural  color. 


IN    NEW-YORK. 


155 


On  Tuesday,  the  third  day,  the  medicine  was 
discontinued,  and  the  patient  took  gruel  with  more 
appetite. 

On  Wednesday,  the  fourth  day,  he  walked  out. 

Remarks. — There  was  occasionally  a  case  of  Cho- 
lera in  the  city,  about  this  time,  but  no  reports  of 
them  were  published.  In  respect  to  want  of  pre- 
valence this  case  was  sporadic  ;  but  it  was  evidently 
of  the  same  nature  as  the  Asiatic  or  epidemic  Cho- 
lera. There  was  no  known  occasional  cause,  nor 
any  thing  in  the  habits  of  the  patient  to  which  the 
disease  could  be  attributed.  I  am  of  opinion,  that 
the  poison,  in  a  dilute  form,  is  among  us. 

CASE  15.  -In  1854,  on  Sunday,  May  21st,  at 
four  o'clock  in  the  morning,  a  lady  was  suddenly  at- 
tacked with  diarrhoea,  after  having  eaten,  on  the 
previous  day,  Rhubarb  pie  at  dinner.  Had  several 
very  large,  watery  and  lightish  brown  stools,  "as 
though"  she  "  had  taken  a  large  dose  of  Calomel." 
Frequent  but  smaller  stools  during  the  day.  She 
again  eat  a  piece  of  Rhubarb  pie. 

On  the  next  morning,  Monday,  the  diarrhoea  re- 
sumed its  original  violence  at  the  hour  correspond- 
ing to  that  of  the  primary  attack,  four,  A.  M.  The 
lady  had,  at  that  hour,  a  return  of  the  copious  and 
watery  evacuations.  Through  the  day,  Monday  the 
second  day,  had  smaller  ones  of  the  same  watery 
character,  more  frequent  after  eating.  Face  pale. 
Eat  freely  of  rice-pudding.  About  ten  o'clock  in  the 
evening,  at  the  suggestion  of  a  physician  who  was 


156  CASES  OF  CHOLERA 

visiting  one  of  the  family,  she  took  Bi-carbonate  of 
Soda,  in  table-spoonful  doses  of  a  solution  made  by 
dissolving  a  tea-spoonful  of  this  salt  in  two  thirds  of 
a  tumblerful  of  water  ;  which  was  to  be  given  two  or 
three  times,  and  followed  by  one-drop  doses  of  tinc- 
ture of  Camphor  after  each  evacuation.  She  took 
these  during  the  night ;  five  doses  of  the  former  and 
fifteen  of  the  latter.  After  three  of  the  Soda  and 
several  of  the  Camphor,  becoming  worse,  and  attri- 
buting this  to  the  want  of  sufficient  Soda,  she  took 
two  more  doses,  but  without  improvement ;  then  con- 
tinued the  Camphor0,  as  before.  The  Camphor  on 
sugar  producing  nausea,  she  afterwards  took  it  in 
water,  recollecting  that  I  had  thus  prepared  it  for 
her  father.  After  this  change  in  the  preparation, 
she  experienced  no  nausea  from  the  Camphor.  The 
diarrhoea,  as  on  previous  nights,  worse  at  and  after 
four  o'clock ;  stools  individually  less  copious  than  in 
the  preceding  night,  but  more  numerous  and  more 
watery  and  colorless.  These  last  features  excited 
no  alarm,  as  she  thought  they  might  arise  from 
some  salutary  action  of  the  Camphor.  The  diarrhoea 
continued  during  the  night  and  morning,  at  inter- 
vals on  an  average  of  less  than  half  an  hour,  up  to 
the  time  of  my  first  visit  and  prescription  of  poten- 
tized  Camphor.  Stools  whitish  and  watery,  some 
colorless,  some  like  milk  mixed  with  an  equal  quan- 
tity of  a  solution  of  coffee,  others  like  water  contain- 
ing yellowish  white  curd-like  sediment.  Awake 
nearly  the  whole  night,  when  sleep  commenced  being 


IN    NEW-YORK.  157 


almost,  immediately  awoke  by  the  diarrhoea  or  the 
premonitory  pain  in  the  abdomen.  In  addition  to 
the  ordinary  pains,  there  were  at  times  abdominal 
cramps.  About  six  times  in  the  night,  had  intole- 
rable cramps  in  the  calves  of  the  legs,  a  symptom 
which  she  had  never  before  experienced  in  any  de- 
gree, in  any  part  of  the  legs,  except  during  an  attack 
of  Cholera  in  the  epidemic  of  1832. 

On  Tuesday  morning,  the  third  day,  at  nine  o'clock, 
I,  being  her  physician,  was  requested  to  visit  her 
immediately,  and  called  in  a  quarter  of  an  hour. 
The  patient  and  her  servants  were  forcibly  struck 
with  the  great  change  in  her  complexion,  the  very 
dark  color  of  her  face  and  hands.  I  found  her  face 
and  hands  of  an  unnaturally  dark  color,  and  the  skin 
of  the  hands  much  wrinkled,  and  so  inelastic  as  to 
retain  for  a  considerable  time  any  folds  into  which 
it  was  drawn  or  pinched  up  with  the  fingers.  Lips 
decidedly  bluish ;  pulse  small,  feeble  and  eighty-four. 
Sensation  of  general  coldness,  as  if  the  body  were  ex- 
posed to  a  cool  breeze  ;  this  coldness  more  this  morn- 
ing than  previously.  The  watery  diarrhoea  continued ; 
the  same  frequency  of  evacuations.  Sensation  of  dry- 
ness  of  the  mouth  and  throat ;  desires  drink  often,  but 
in  small  quantities.  I  immediately  administered  a 
few  dry  pellets  of  Camphor  30,  and  .prepared  three 
other  similar  doses  to  be  given  once  in  half  an  hour, 
also  a  solution  of  Arsenicum  30,  to  be  commenced  at 


158  CA3ES  OP  CHOLERA 

repeated  hourly.    After  two  doses  of  the  30th  of  Cam- 
phor she  felt  decidedly  better,  I  perceived  that  the 
skin   of  the  face   and  hands  had  greatly  improved 
in  color,  and  that  of    the  latter  had  lost  much  of 
of  its  corrugation.    After  commencing  this  medicine, 
in    this  attenuated   form,  the   patient   was    exempt 
from  diarrhoea  for   about  two  and  a  half  hours — a 
respite  unprecedented  during  this  illness.     NQ  stool 
until  about  noon,  a  few  minutes  after  taking  the  first 
dose  of  the  30th  of  Arsenicum.     The  stools  in  the 
afternoon  and  evening  were  only  about  half  a  gill 
each,  being  scarcely  one-fourth  as  great  as  previously, 
though  they  were  passed  at  about  the  same  inter- 
vals, and  were    still  liquid,  but  of  a  browner  and 
more   normal   color.     Pulse  74,    still   rather   feeble. 
Some  pains  in  the  abdomen  each  time  after  taking 
beef  broth,  the  diet  and  drink  used  through  the  day. 
I  saw  her  a  quarter  before  nine  in  the  evening, 
•when  she  felt  much  better  than  in  the  morning,  but 
still  feeble,  and  complained  of  aching  and  sensation 
of  fulness  in  the  anterior  part  of  the  head.     I  ad- 
vised a  little  ice-water,  the  drinking  of  which  was 
immediately  followed  by  a  warm  but  partial  perspi- 
ration, confined  to  the  forehead,  face,  chest,  hands 
and  arms.     This  sweat  being  warm,  and  being  the 
first  instance,  since  the  attack,  of  moisture  appearing 
on  the  skin,  was,  though  partial,  a  somewhat  favor- 
able sign.     But  the  evidences  of  congestion  of  the 
brain  still  remaining,  and  several  symptoms  including 
some  of  the  particular  localities  of  the  headache  and 


IN    NEW-YORK.  159 


perspiration,  also  indicating  Camphor,  and  the  small, 
brownish,  watery  stools  still  recurring  at  the  same 
short  intervals,  I  determined  to  resume  its  use  in 
the  form  of  the  same  dynamization  which  had  proved 
so  effectual  in  arresting  the  evacuations  in  the  fore- 
noon ;  and  accordingly,  a  few  minutes  after  nine 
o'clock,  prescribed  four  doses  of  the  30th  potency, 
to  be  taken,  in  the  form  of  dry  pellets/;  at  intervals 
of  a  quarter  of  an  hour — i.  e.,  4  Camph.  30,  •}  h. 
After  resuming  this  medicine,  she  had  only  two 
stools,  one  a  quarter  before,  the  other  a  quarter 
after  ten  o'clock,  that  evening,  the  former  a  gill,  the 
latter  a  table-spoonful,  the  color  and  consistence  un- 
changed. The  aching  and  fulness  of  the  head  was 
removed  ;  the  patient  became  comfortable,  and  soon 
fell  into  a  sound  sleep,  which  continued  through  the 
whole  night.  Had  no  return  of  the  evacuations. 
Next  morning  she  awoke  perfectly  comfortable,  and, 
at  the  time  of  my  visit  at  ten  o'clock,  was  sitting  in 
a  chair,  and  presenting  her  usual  appearance  of 
blooming  health.  After  the  half  ounce  evacuation, 
which  in  about  a  quarter  of  an  hour  had  followed  the 
last  dose  of  potentized  Camphor,  given  on  the  previous 
evening,  the  convalescent  patient  had  no  stool  what- 
ever for  twenty-four  hours,  then  a  small  one  of  na- 
tural color  and  fair  consistence. 


160  CASES  OF  CHOLERA 


GASTRIC     CHOLERA. 

CASE  16. — A  nephew  of  Madame  Ilahnernann, 
and  son  of  Mr.  D'H.,  16  months  old,  still  at  the  breast, 
awoke  out  of  sleep  at  12  o'clock,  on  the  night  of  the  15th 
of  June,  1849,  with  vomiting,  forcibly  ejecting  the 
contents  of  the  stomach  "with  a  jerk."  This  vomit- 
ing was  repeated  every  few  minutes,  for  about  an 
hour  and  a  half,  becoming  more  watery,  until  it 
appeared  like  pure  water.  Edward  Bayard,  M.D. 
saw  the  patient  at  one  o'clock  that  night.  Eyes 
sunken,  with  dark,  bluish  circles  around  them ;  fea- 
tures pinched.  Relaxation  and  heaviness  over  the 
whole  body ;  extreme  languor,  with  total  apathy 
except  at  the  time  of  vomiting.  Marbly  cold  sweat 
on  the  face  and  upper  parts  of  the  body,  with  dry- 
ness  of  the  feet  and  legs.  The  mother,  after  con- 
sulting Dr.  Joslin's  book,  had  administered  five  one- 
drop  doses  of  Camphor,  at  intervals  of  five  minutes. 

Dr.  Bayard  believing  that  the  child  was  oppressed 
by  the  power  of  the  drug,  determined  to  wait  for  the 
reaction  for  thirty  minutes.  About  the  expiration 
of  that  time,  the  mother  remarked  that  the  child  was 
dying;  and  it  was  evident  that  the  symptoms  were  be- 
coming more  intense.  The  Doctor  believing  that  Cam- 
phor was  still  indicated,  determined  to  give  the  third 
dilution,  of  which  he  had  a  few  pellets  in  his  box. 
Three  dry  pellets  of  this  dilution  were  placed  upon 
the  child's  tongue.  He  vomited  once  after  taking 


IN    NEW-YORK.  161 


it ;  the  vomiting  then  ceased.  In  thirty  minutes 
the  dose  was  repeated.  The  sweat  dried  up,  the 
apathy  and  languor  passed  away;  and  in  an  hour 
after  taking  the  first  dose,  the  child  rose  up  and 
played.  So  convinced  was  the  mother,  that  her 
child  had  been  plucked  as  it  were  from  the  jaws 
of  death,  by  the  small  dose,  that  she  fell  upon  her 
knees  and  thanked  God  for  the  gift  of  Homceopathia. 

CASE  17. — An  unmarried  gentleman,  a  merchant, 
aged  25,  was  attacked  on  Monday  morning,  July  9th, 
1849.  The  first  symptom  was  vomiting  with  cold- 
ness of  the  feet,  legs  and  face.  Vomiting,  without 
nausea ;  a  whitish,  grey  liquid,  like  prepared  starch, 
containing  white  flocks,  spirted  out  violently.  After 
two  vomitings,  he  had  one  loose  stool,  then  two 
more  vomitings.  According  to  previous  instruc- 
tions, he  immediately  resorted  to  Camphor,  in  drop 
doses,  and  continued  it  every  five  minutes,  until  he 
received  Veratrum  30,  that  is  until  the  messenger 
could  bring  it  from  my  office,  a  mile  and  a  half 
distant.  I  called  on  him  at  eleven,  A.  M.,  and  found 
his  tongue,  feet,  legs  and  forehead  cold.  Severe 
pain  in  the  abdomen.  Urine  suppressed.  After  the 
Veratrum  30,  which  he  had  taken,  I  gave,  in  the 
following  order:  2  Verat.  12,  1  Nux-vom.  30,  2  Ar- 
senicum  30,  and  1  Verat.  12.  Then,  the  more  urgent 
symptoms  being  relieved,  I  prescribed  Verat.  *°,  in 
solution,  at  one-hour  intervals,  as  long  as  necessary. 

On  the  day  after  that  of  the  attack',  he  was  so  far 
restored,  that-  the  Veratrum  J03  was  ordered  only 


162  CASES    OP    CHOLERA 

three  times  a  day,  to  be  taken  for  two  days  if  neces- 
sary. No  other  visit  or  prescription  was  needed ;  but 
I  ascertained  on  the  fifth  day,  that  the  recovery  had 
been  complete  under  the  Veratrum  3-°,  probably  in 
less  than  three  days  from  the  time  of  attack. 


SPASMODIC     CHOLERA. 

CASE  18. — After  having  for  a  week  or  two  a 
watery  diarrhoea,  without  treatment  or  medical  ad- 
vice, a  married  lady  was  attacked  with  Cholera  of 
the  Spasmodic  variety,  about  half-past  nine  o'clock 
in  the  evening  of  Monday,  January  29th,  1849.  I 
saw  her  in  an  hour  from  the  time  when  the  disease 
assumed  this  form. 

After  a  single  vomiting  of  some  sour  material,  the 
patient  was  attacked  with  spasms,  first  as  cramps  in 
the  calves  of  the  legs ;  then  severe  tonic  spasms 
of  the  whole  of  both  inferior  extremities  ;  these  tonic 
spasms,  soon  extending  upwards,  successively  to  the 
abdomen,  stomach,  chest  and  throat.  The  paroxysms 
recur  simultaneously  in  the  muscles  of  all  those  re- 
gions, from  the  legs  to  the  throat,  inclusive.  The 
inferior  limbs  are  spasmodically  extended  and  ex- 
tremely stiff  and  hard,  and  affected  with  excruciating 
pain. 

Among  the  other  results  of  spasms,  there  are 
present ;  a  hard  swelling  at  the  stomach,  respiration 
almost  arreste'd,  sense  of  extreme  suffocation,  and 
deglutition  difficult,  sometimes  impossible.  The 


IN    NEW-YORK.  163 


spasms  relax,  and  after  a  few  minutes  return  with 
the  same  severity.  Lastly,  spasms  of  the  muscles 
of  the  jaw,  attended  with  grating  of  the  teeth. 

R.  Tincture  of  Camphor,  one  or  two  drops,  given 
in  sugared  water,  every  five  minutes,  until  there  was 
a  diminution  of  the  spasms  ;  then  2  Cuprum-metal- 
licum  30,  at  intervals  of  half  an  hour.  Afterwards5 
there  being  retching,  and  vomiting  of  a  very  small 
quantity  of  froth,  there  was  given,  1  Verat.  12,  and 
3  Verat.  30,  all  at  intervals  of  one  and  a  half  hours. 

The  3  Verat.  30,  were  given  ft  solution,  and  by 
the  friends,  during  the  night,  the  patient  being  so 
much  improved,  as  no  longer  to  require  the  constant 
attendance  of  a  physician. 

Next  morning,  Tuesday,  the  second  day,  the  pa- 
tient feels  comfortable,  with  the  exception  of  a  sen- 
sation of  soreness.     This  was  undoubtedly  an  effect 
of  the  spasms.     A  few  more  doses  of  Verat.  30,  were 
given  on  that  day,  at  intervals  of  two  hours.     The 
patient  having  recovered,  no  other  medicine  was  given. 
Remarks. — The    Cholera  had  been  reported  the 
preceding  month,   but  was  not  prevalent  until  the 
latter  part   of  the   ensuing   spring. — This   was   the 
first  case  in  1849.     The  poison  in  the  atmosphere 
was  probably  very  dilute  in  this  cold  season,  yet 
was  sufficient  with  some  peculiar  constitution  of  the 
patient  and  after  a  week  or  two  of  diarrhoea,  to  de- 
velope  the  disease.     This,  and  the  two  following,  all 
spasmodic,  are   the   only  winter   cases   of  Cholera, 


104  CASE3    OP    CnOLERA 


which  have  come  under  my  observation.  From  such 
an  experience  I  conjecture,  that  the  cold  season  is 
less  unfavorable  to  the  development  of  the  spasmodic 
than  of  other  forms  of  Cholera. 

CASE  19. — A  young  unmarried  man,  recently  en- 
gaged in  painting,  was  attacked  with  Spasmodic 
Cholera,  on  Tuesday,  Feb.  27th,  1849,  about  five 
o'clock  in  the  evening.  Feeling,  at  first,  spasms  in 
the  shoulder,  he  took  an  allopathic  dose  of  tartar 
emetic ;  in  an  hour  or  two  he  vomited ;  then  had  ;i 
few  loose  stools  ;  tlpn  vertigo,  and  considerable  deaf- 
ness ;  then  tonic  spasms,  excited  and  increased  by 
movement  of  the  parts.  The  spasms  commenced  in 
the  calves,  and  extended  to  the  whole  inferior  extre- 
mities, the  abdomen,  and  the  stomach.  Painful  tonic 
spasms  rendered  the  lower  limbs  inflexible.  The 
rertigo  and  deafness  continued  with  the  spasms. 
The  patient  was  deaf  more  especially  to  the  sound  of 
his  own  voice,  the  hearing  of  which  seemed  to  him 
prevented  by  the  rumbling  of  his  voice  in  his  head. 
Great  thirst.  Vomiting  once  more  of  a  watery  liquid 
with  mucus,  part  of  the  ejected  liquid  being  of  a 
milky  white  color.  The  fluid  spirted  from  the  mouth 
to  the  distance  of  about  two  yards,  as  estimated  in  a 
horizontal  direction.  The  spasms  continued,  with 
marbly  coldness  of  the  feet,  chin,  nose,  and  tongue ; 
face  bluish- pale. 

Treatment  and  effects. — Tincture  of  Camphor  in 
five  doses,  too  large,  and  at  intervals  too  long,  had 
been  given  by  the  family,  in  about  eighty  minutes 


IN    NEW- YORK.  165 


that  elapsed  before  my  arrival.  These  were  without 
apparent  effect.  I  gave  a  single  drop  dissolved  in 
sugared  water,  once  in  five  minutes.  The  spasms 
were  in  some  degree  mitigated  in  two  hours  after  the 
first  administration  of  Camphor,  or  forty  minutes  af- 
ter commencing  the  use  of  it  in  small  doses — of  which 
eight  were  given.  Then  Cuprum  30  was  given,  in 
doses  of  three  globules  each,  in  a  dry  state.  The 
first  dose  of  Cuprum  produced  a  very  decided  miti- 
gation of  the  spasms,  restored  warmth  to  the  chin, 
and  prevented  the  recurrence  of  the  vomiting.  Two 
more  doses  of  this  medicine  at  intervals  of  an  hour,, 
removed  the  spasms  entirely.  Another  dose. of  it 
was  given  an  hour  afterwards  to  prevent  their  return. 
The  spasms  never  returned.  No  real  diarrhoea  oc- 
curred till  next  morning,  when  there  were  two  watery 
stools,  for  which  was  given  Verat.  30,  in  solution. 
The  patient,  when  visited  on  that  morning,  (Wednes- 
day, the  2d  day,)  was  already  sitting  up,  and  feeling 
comfortable.  The  last  dose  of  Veratrum  was  taken 
on  the  following  morning,  Thursday,  the  3d  day, 
when  he  was  well. 

Cause. — I  believe  this  case  of  spasmodic  cholera 
to  have  required  for  its  development  the  presence,  in 
the  atmosphere  of  our  city,  of  some  portion  of  that 
poison  which,  in  a  warmer  season  would  have  render- 
ed the  disease  in  some  form  epidemic.  The  case  in 
the  previous  month  had  convinced  me  that  this  cause 
was  among  us.  Nearly  all  of  the  symptoms  of  the 
present  case  are  those  of  epidemic  cholera,  and  some 

Q* 


166  CASES  OF  CHOLERA 

of  them  peculiarly  characteristic.  The  deafness, 
however,  is  not  usual.  The  patient  for  about  a  week 
had  been  engaged  in  painting  window-blinds,  and  in 
that  occupation  had  been  exposed  to  the  influence  of 
green  paint,  the  basis  of  which  was  copper.  He  may 
have  absorbed  a  sufficient  quantity  of  this  to  aid  the 
inception,  and  have  taken  enough  of  tartar  emetic  to 
produce  an  exacerbation  of  a  disease,  which  from  the 
action  of  the  essential  cause  alone,  i.  e.,  the  atmos- 
pheric poison,  would  not  have  occurred  in  any  degree 
which  would  have  justified  us  in  considering  and  re- 
porting it  as  a  case  of  Asiatic  Cholera.  We  know 
that  even  when  the  disease  is  epidemic,  the  attack  of 
an  individual  usually  requires  both  a  predisposing 
and  an  occasional  cause,  in  addition  to  that  essential 
cause  which  imparts  to  the  symptoms  their  peculiar 
character. 

CASE  20. — This  was  somewhat  more  complicated 
than  the  two  preceding,  yet  as  the  spasms  in  their  se- 
verity, extent,  and  persistence,  were  prominent  symp- 
toms, it  may  properly  enough  be  considered  as  be- 
longing to  this  variety.  As  I  deemed  it  my  duty, 
though  not  required  by  law  at  that  season,  to  keep 
the  authorities  apprised  of  the  occurrence  of  any 
such  case,  although  it  might  be  so  far  as  I  knew  spo- 
radic, I  reported  it  to  the  Mayor.  As  most  of  my 
records  of  this  case  are  mislaid.  I  extract  the  follow- 
ing from  a  copy  of  the  letter  which  relates  to  it. 

"NEW-YORK,  Feb.  21st,  1850. 
$ — I  hereby  report  one  case  of  Cholera.     The 


IN    NEW- YORK. 


16T 


patient  is ,  a  collector,  aged  64  years.     As  this 

case  occurs  so  early  in  the  year,  that  you  might  doubt 
its  genuineness,  I  think  it  proper  to  mention  some 
of  its  characteristics.  Diarrhoea  ;  vomitings  ;  severe 
cramps  in  the  fingers,  arms,  toes,  legs,  thighs,  and 
chest ;  urine  scanty,  now  suppressed ;  coldness  and 
blueness  of  the  skin ;  anterior  part  of  the.  tongue 
cold  as  marble.  Attack  at  eight  o'clock  last  evening, 
No  medical  treatment  for  more  than  twelve  hours.  I 
was  applied  to  at  eight  this  morning,  sent  medicine, 
and  saw  him  at  nine.  The  evacuation  which  I  saw, 
was  entirely  like  rice-water,  with  a  sediment  of  white 
particles,  like  boiled  rice." 

The  patient  was  in  such  pain  and  jeopardy,  col- 
lapse being  imminent,  if  not  already  commenced,  that 
he  was  visited  five  times  on  this,  second  day.  The 
treatment  was  Cuprum  30,  Camphor  3,  and  Vera- 
trum  30,  in  solution.  They  were  given  in  the  above 
order,  but  not  alternately.  The  patient  being  im- 
proved, was  left  with  directions  to  continue  the  same 
solution,  Veratrum  30.  The  next  morning,  Friday 
the  third  day  of  the  disease,  and  the  second  of  the 
treatment,  the  patient  was  found  convalescent,  and 
directed  to  take  Veratrum  30,  only  morning  and  eve- 
ning. On  the  following  day,  Saturday,  the  fourth  of 
the  disease,  and  the  third  of  the  treatment,  he  was 
so  far  recovered,  as  to  take  only  one  dose  of  Vera- 
trum 30.  The  treatment  was  then  discontinued,  and 
the  result  reported  at  the  earliest  opportunity — Mon- 
day morning. 


168  CASES    OF  CHOLERA 

Note. — One  object  in  being  thus  careful  to  report 
tbe  existence  of  every  case,  and  the  result,  was  to 
contribute  my  share  towards  giving  the  authorities 
all  the  information  requisite  for  their  guidance,  in 
reference  to  their  hygienic  functions  ;  another  was  to 
give  them  the  means  of  verifying  the  reports,  and 
thus  to  render  the  latter  more  official  and  reliable  in 
statistics.  In  the  present  case,  however,  fhe  season 
of  the  year  rendered  the  former  object  less  impor- 
tant ;  and  the  latter  object  has  not  yet  been  subserv- 
ed by  it,  as  the  statistics  given  in  this  book  include 
no  cases  occurring  since  1849. 


DRY     CHOLERA. 

CASE  21.— On  the  night  of  Tuesday,  June 
26th,  1849,  about  11  o'clock,  Capt.  W.,  an  un- 
married man,  aged  about  28,  was  attacked.  For 
about  three  or  four  weeks  he  had  been  living 
very  freely,  having  just  returned  from  sea.  For 
some  days  he  had  been  eating  as  well  as  drinking  to 
excess.  Was  visited  by  James  M.  Quin,  M.  D.,  at 
midnight.  The  Doctor  found  that  the  patient  had 
been  seized  with  vomiturition  without  vomiting,  and 
urgent  disposition  to  stool,  without  stool.  In  this 
condition  he  was  brought  by  his  attendants,  from  an 
out-building  to  bed,  at  which  time  he  was  seen  by 
the  Doctor.  Ilis  pulse  was  full,  bounding,  and  110. 
The  head  excessively  hot,  with  great  mental  distress 
and  anxiety.  The  rest  of  the  body,  especially  the 
extremities,  were  characteristically  cold  and  clammy, 


IN    NEW-YORK.  169 

tongue  and  breath  cold.  The  calves  of  the  legs  were 
very  much  cramped,  and  the  belly  was  filled  with 
horrible  tormina  ;  the  patient  writhed  into  every  pos- 
sible position,  from  excess  of  agony. 

The  treatment,  which  lasted  from  that  time  until 
four  o'clock  in  the  morning,  at  which  time  the  patient 
was  convalescent,  consisted  of  the  tincture  Campffor, 
and  Veratrum  of  the  sixth  attenuation,  internally 
and  externally,  of  bottles  of  hot  water  applied  exten- 
sively to  the  body,  particularly  to  the  calves  of  the 
legs  and  the  inside  of  the  thighs.  Another  point  to 
which  the  bottles  of  hot  water  were  applied,  was  im- 
mediately over  the  kidneys.  As  a  verification  of  the 
correctness  of  this  application,  the  first  permanent 
relief  which  the  patient  experienced  was  signalized 
by  a  copious  emission  of  pale  watery  urine.  At  first 
the  treatment  consisted  of  Camphor  tincture  alone,  a 
drop  every  three  minutes  for  about  the  first  half  hour, 
and  for  the  next,  every  five  minutes.  This  remedy, 
besides  its  specific  character,  was  particularly  adapt- 
ed to  the  patient's  then  existing  condition  of  brain. 
The  cramps  in  the  calves  of  the  legs,  however,  con- 
tinuing with  unabated  violence,  indicated  strongly 
the  use  of  Veratrum ;  and  under  the  use  of  this  reme- 
dy, the  cramps  in  the  calves  of  the  legs  subsided  in 
less  than  thirty  minutes,  and  a  profuse  warm  perspi- 
ration broke  out  over  the  whole  body.  From  this 
moment  the  patient  got  rapidly  better,  and  the  medi- 
cines were  continued,  but  at  considerably  lengthened 
intervals.  Dr.  Quin  left  him  at  four  o'clock,  haying 


170  CASES  OF  CHOLERA 

been  incessantly  with  him  for  four  hours.  Up  to  this 
time,  no  evacuation  by  the  bowels  had  taken  place. 
T|ie  patient  slept  from  this  time  till  about  noon,  when 
he  had  a  natural,  soft,  but  consistent  stool. 


ACUTE    CHOLERA. 

CASE  22.— Attack,  Monday,  May  28th,  1849.— 
The  patient,  a  married  woman,  aged  45,  was  not  seen 
until  she  had  been  suffering  for  nearly  four  hours 
from  an  attack  of  severe  Cholera,  unpreceded  by  any 
premonitory  diarrhoea.  The  case  then  presented  the 
appearance  of  a  combination  of  the  spasmodic  and 
gastro-enteric  varieties.  It  appears  from  the  descrip- 
tion of  Cholera-acuta,  as  given  by  Dr.  F.  F.  Quin, 
and  to  a  considerable  extent  copied  in  this  book,  that 
this  variety,  in  its  second  stage,  may  present  this 
complicated  aspect.  As  the  case  was  not  seen  in  the 
first  stage,  it  is  impossible  to  say  whether  it  then 
presented  evidence  of  that  sudden  and  violent  im- 
pression on  the  nervous  system  which  characterizes 
an  attack  of  acute  cholera.  Its  subsequent  course 
corresponded  sufficiently  well  with  the  description  of 
this  variety,  and  especially  with  the  modification  of 
which  has  been  proposed,  p.  121. 

The  patient  was  a  stranger  to  me  and  to  the  homceo-j 
pathic  practice.  She  lived  in  my  vicinity,  and  pro- 
bably endeavored  to  obtain  the  nearest  physician, 
after  failing  to  .secure  the  attendance  of  her  family 


IN    NEW  YORK.  171 


physician,  who  was  an  allopathist,  and  who,  by  an 
office  prescription,  preceded  me  in  the  treatment  of 
the  case.  The  attack  was  about  10,  P.  M.  I  first 
saw  the  patient  about  2,  A.  M.,  her  physician  not 
being  able  to  visit  her  in  the  night.  After  the  at- 
tack, she  had  taken,  either  by  his  advice  or  of  her  own 
accord,  a  dose  consisting  of  ten  drops  of  Camphor, 
mixed  with  a  teaspoonful  of  Laudanum,  what  else,  is 
not  known.  Collapse  was  already  approaching,  the 
pulse  very  feeble,  and  the  cramps  severe.  For  a 
more  particular  account  of  these,  of  the  evacuations 
upwards  and  downwards,  of  the  coldness  and  other 
symptoms,  and  of  a  remarkable  phenomenon  observed 
after  death,  the  reader  is  referred  to  the  Appendix, 
written  by  one  who  assisted  in  the  treatment  of  the 
case,  and  who  some  years  since  had  occasion  to  use  it 
in  an  essay. 

3.  Camph.  -rV,  a  drop  every  five  minutes.  This 
with  two  doses  of  Veratrum  '2,  and  30,  and  two  of 
Cuprum  30,  constituted  the  treatment  for  the  first 
two  hours  after  we  were  called.  Then  Secale  1 2  and 
Cuprum  3  ° .  Afterwards,  about  five  doses  Camph.  TV, 
gt.  j.  as  before. 

CASE  23.— Monday,  July  30th,  1849.  A  girl, 
aged  8  years,  was  well  till  four  o'clock  this  morning ; 
then  diarrhoea  commenced.  Four  brown  stools  of  a 
gruelly  consistence,  in  four  and  three  quarter  hours, 
at  the  end  of  which  time  she  was  first  visited,  and 
found  in  a  state  of  collapse.  There  had  not  been 


172  CASES    OF    CHOLERA 

more  than  a  quart  of  the  stools  in  all  — i.  e.  one-half 
pint  each.  The  body  was  almost  universally  cold, 
quite  as  cold  as  a  corpse  usually  is  several  minutes 
after  death,  and  covered  with  a  cold  and  clammy 
perspiration.  Face  bluish,  and  hands  bluish  and 
wrinkled.  Desire  for  ice.  Voice  reduced  to  a 
whisper. 

ij.  Camph.  gt.  j.  every  five  minutes.  After  about 
four  of  these  one-drop  doses,  she  had  a  serous  stool 
with  a  copious  ricey  sediment.  But  the  whole  was 
only  about  a  gill  and  a  half,  i.  e.  six  ounces. 

There  is  no  farther  record  of  the  treatment.  The 
patient  died  about  noon,  about  three  hours  from  the 
time  of  the  physician's  first  visit,  and  eight  hours 
after  the  attack,  no  medical  assistance  was  applied 
for  until  collapse  had  taken  place. 

Remarks. — The  discharges  were  not  such,  either 
in  quantity,  consistence  or  color,  as  to  justify  us  in 
considering  this  a  case  of  Cholera,  unless  the  other 
symptoms  had  been  present.  This,  and  the  follow- 
ing case,  in  which  the  result  was  favorable,  were 
under  the  treatment  of  my  son,  B.  F.  Joslin,  Jr. ; 
but  as  he  was  at  that  time  an  under-graduate,  they 
were  reported  and  numbered  with  mine.  I  saw  them 
in  consultation.  Both  cases  were  acute  in  the  sud- 
denness of  the  invasion,  and  the  rapidity  of  their 
progress  to  collapse,  and  this  one  at  least,  without 
any  adequate  cause  in  the  quantity  of  the  evacua- 
tions. They  were  not  even  ricey  or  watery,  until 


IN    NEW-YORK.  173 


after  full  collapse  had  been  established  and  the  treat- 
ment commenced,  and  there  was  no  evidence  of  any 
considerable  amount  of  serous  material  that  had  been 
until  then  retained. 

CASE  24.—  A  girl,  aged  7£,  was  attacked  about 
four  and  a  half,  P.  M.,  Thursday,  Aug.  16th,  1849. 
The  disease  commenced  with  diarrhoea  and  vomit- 
ing. Was  seen  before  the  collapse  was  complete. 
Then  took  one-drop  doses  of  tincture  of  Camphor, 
afterwards  some  doses  of  Camphor  3,  then  was 
treated  with  Veratrum  30.  She  was  in  collapse 
within  two  or  three  hours  from  the  commencement 
of  the  first  symptoms  of  disease.  Pulseless.  Voice 
nearly  lost.  Tongue,  face  and  limbs  cold.  Cramps. 
Urine  suppressed.  In  the  evening  she  was  put 
under  Carbo-veg.  30  and  Cuprum-metal.  zo,  alternate- 
ly every  half  an  hour. 

Friday,  the  second  day,  in  the  morning. — After 
remaining  in  this  state  of  collapse  for  twelve  hours, 
entirely  pulseless,  reaction  came  on  in  the  morning, 
under  the  continued  use  of  the  Carb.-v.  io  andCupr.10 
given  as  above  mentioned.  The  pulse  and  voice  were 
restored,  and  the  tongue  and  most  of  the  skin  acquired 
a  temperature  nearly  normal.  The  same  treatment 
was  continued. 

Saturday,  the  third  day.  A  stool  nearly  normal, 
except  as  to  consistence,  which  was  that  of  mush — 
i.  e.  semi-fluid.  Reaction  about  complete.  Tempe- 
rature normal.  The  recovery  was  oson  complete. 


174  CASES    OF   CHOLERA 

Remarks. — This  case,  in  respect  to  the  rapidity 
with  which  the  patient  sank  into  collapse,  was  more 
acute  than  the  preceding.  The  amount  of  evacua- 
tions was  not  definitely  ascertained,  but  could  not 
have  been  remarkable.  As  in  the  preceding  case, 
my  son  was  the  attending  physician,  and  I  visited  in 
consultation. 

The  locality  in  which  this  case  occurred  was  ex- 
tremely unfavorable,  and  the  disease  there  remark- 
ably malignant  and  fatal,  especially  under  the  old 
treatment.     I  learned  from  the  father  of  the  above 
child,  who,  though  poor,  was  a  respectable  and  intelli- 
gent American,  that  all  the  cases  which  had  occurred 
in  that  filthy,  blind  alley  or  court-yard,  and  had  been 
treated  allopathically  either  there  or  at  the  hospi- 
tals, had  died.*     Being  aware  of  the  danger  to  which 
his  family  was  exposed,  he  had  represented  the  state 
of  things  (perhaps  not  fully)  to  the  City  Inspector, 
in  May.     At   the   commencement  of  the   epidemic, 
there  were  four  small  adjoining  houses,  containing 
twenty-eight  families,  in  this  ccecum  or  blind  hole,  filled 
with  the  stench  of  three  privies  full  of  putrefying 
materials.     Nine  of  the  families  had  left  in  a  panic 
when  they  saw  so  many  of  their  friends  and  neigh- 
bors attacked,  and  that  an  attack  there  was  the  visi- 
tation of  death. 


•  The  number  which  had  occurred  previously  to  that  time,  the 
16th,  was  said  to  be  nine. 


IN    NEW-YORK.  175 


The  privies  remained  completely  full,  and  there 
were  still  on  the  16th,  nineteen  families  occupying 
the  premises.  In  behalf  of  these  poor  people,  I 
deemed  it  my  duty  on  the  occurrence  of  the  above 
case,  to  represent  the  condition  of  the  place  to  the 
President  of  the.  Board  of  Health,  and  to  make  a  sug- 
gestion of  a  remedy.  As  this  may  be  of  use  to 
others,  at  a  time  when  to  clean  vaults  may  be  as 
dangerous  as  to  leave  them  full,  I  give  from  the 
letter,  an  extract  relating  to  it. 

"  With  the  best  means  of  preventing  any  deleterious 
gases  and  vapors  from  ascending  from  the  vaults, 
the  City  Inspector  is  probably  acquainted ;  but  I 
take  the  liberty  of  suggesting  a  cheap  preparation  ; 
which  some  gentlemen  have  used  with  great  success. 
They  take  half  a  pailful  of  pulverized  gypsum,  half  a 
pailful  of  pulverized  charcoal,  and  one  pound  of 
copperas.  When  these  have  been  intimately  mixed, 
the  powder  is  strewed  over  the  sides  and  contents  of 
the  vault.  It  forms  a  crust  over  the  latter,  and  keeps 
the  air  above,  pure  for  a  week.  At  the  end  of  that 
time,  the  above  quantity  is  to  be  again  put  into  each 
vault.  If  the  habitations  of  all  the  poor  people  of 
this  city  were  thus  protected  by  the  Corporation,  it 
would  diminish  the  city  expenses,  and  save  many 
lives." 


176  CASES  OF  CHOLERA 

GASTRO-ENTERIC    CHOLERA 

CASE  25. — Miss ,  aged  about  27,  was  attacked 

Thursday,  July  26th,  1849,  at  ten,  P.  M.  At  six 
o'clock  next  morning  I  was  called  from  bed  to  visit 
her.  The  distance  being  a  mile  and  a  half,  it  was 
seven  o'clock  before  she  was  prescribed  for.  She 
had  had  diarrhoea  for  a  week,  and  checked  it  from 
time  to  time  by  brandy.  At  ten,  P.  M.  of  the  26th, 
after  a  tea  of  rusk,  and  rice  pudding  containing  eggs, 
she  had  a  large,  loose  alvine  evacuation,  which  was 
followed  by  vomiting.  The  alvine  evacuations  and 
vomitings  continued  through  the  night  and  until  the 
time  of  my  visit  and  prescription.  There  had  been 
eight  or  nine  of  each,  that  is  the  total  number,  up- 
wards and  downwards,  was  sixteen  or  eighteen.  The 
stools  were  of  a  serous  andricey  character— a  watery 
liquid  with  a  white  ricey  sediment.  At  seven,  A.M., 
9.  Veratrum  3  °,  in  solution,  every  two  hours,  or  after 
each  evacuation,  if  they  occur  oftener.  The  patient 
was  soon  relieved,  and  was  not  again  seen  until  three 
days  afterwards,  when,  for  some  reason,  not  stated  in 
the  record,  she  took  Phos.  *°,  and  six  days  after  the 
attack,  one  Sulph.  800°. 

DYSENTERIC    CHOLERA. 

CASE  26.— On  Wednesday,  July  4th,  1849,  I  was 
called  to  visit  a  married  gentleman,  about  55  years  of 


IN    NEW-YORK.  177 


age.  He  had  occasionally  had  slight  cramps  in  the  feet 
for  about  three  weeks.  On  the  3d  of  July,  at  4,  P.M., 
diarrhoea  commenced  ;  stools  brown  and  foetid.  Much 
pain  in  the  bowels. 

Second  day,  July  4th,  nine,  A.  M.  Has  had  two 
brownish  stools.  Tongue  has  a  brownish  yellow 
coat.  I  prescribed  three  Camph  3,  one  every  half 
hour,  then  Verat.  3  °  in  solution,  after  each  evacuation. 

Four,  P.  M.  Has  had  two  stools  since  commencing 
the  Veratrum  ;  the  last  had  the  liquid  rice-water 
appearance  with  white  flocks,  was  without  pain,  but 
was  preceded  by  cramps  in  the  soles  of  both  feet, 
and  in  the  flexor  muscles  of  the  right  thumb.  Feet 
cold  about  the  time  of  the  evacuations,  but  reaction 
has  come  on :  pulse  now  one  hundred  and  eight. 
Tongue  more  moist  and  less  coated. 

Treatment. — Continue  the(Veratrum  30,  as  before, 
pro-re-nata. 

Ten,  P.  M.  Stools  scanty,  and  of  bloody  mucus 
with  some  whitish  material,  a.  2  Mercurius-viv.12. 

Thursday,  the  third  day,  eight,  A.  M.  Tender- 
ness of  the  stomach  and  hypochondria.  Has  had 
several  small  evacuations  in  the  night,  with  tenesmus 
and  sense  of  pressing  down.  R.  Sulph.  30/ 

From  this  time  the  ricey  and  rice-water  stools 
were  intermingled  with,  and  at  length  replaced  by, 
others  of  bloody  mucus  in  small  quantities.  The 
completion  of  the  cure  of  the  dysenteric  portion  of 
the  case,  required  about  eight  or  nine  days  longer, 


178  CASES  OP  CHOLERA 

and  was  effected  principally  by  Mercurius  30    and 
Sulphur30. 

Remark. — It  was  not  ascertained,  that  previously 
to  the  attack,  there  had  been  any  thing  unusual  in 
the  regimen  or  diet,  except  the  eating  of  peas  at 
dinner,  on  the  day  preceding  the  commencement  of 
the  diarrhoea. 

CASE  27.— Wednesday,  July  4th,  1849.  Nine, 
A.  M.  A  young  married  lady,  was  this  morning 
attacked  suddenly.  First  symptoms,  liquid  stools  in 
large  quantities,  with  pain  in  the  abdomen.  The 
first  prescription  was  3  Camph.  8,  one  every  half 
hour,  then  1  Verat.  12. 

Eleven,  A.  M.,  second  visit.  The  evacuations 
have  been  checked.  The  tongue  has  a  thin  yellow 
coat.  R.  Verat.  30  in  solution,  a  dose  after  each 
evacuation. 

Six,  P.  M.,  third  visit.  Since  the  last  visit,  only 
two  evacuations.  The  stools  small  in  quantity, 
watery  and  slimy,  and  the  last  one,  at  least,  contain- 
ed the  characteristic  ricey  flocks. 

B.  Veratrum  30,  to  be  continued,  a  dose  after  each 
evacuation,  or  once  in  two  hours,  if  there  is  pain, 
even  though  the  evacuations  should  occur  at  inter- 
vals longer  than  this. 

Thursday,  the  second  day,  at  noon.  Stools  of 
bloody  mucus  with  some  whitish  portions.  Pain  and 
tenderness  of  the  abdomen.  R.  Three  doses  of  Aco- 
nitum  8  °  at  intervals  of  two  hours. 


IN   NEW-YORK..  179 


The  patient  was  visited  twice  more  oix  the  same 
day,  and  received  Sulphur  30  in  solution. 

Friday,  the  third  day.  The  patient  convalescent, 
and  left  under  the  action  of  the  previously  taken 
Sulphur,  without  repetition. 

She  recovered  without  any  additional  treatment, 
except  one  dose  of  Sulphur  1 2  °  °  on  the  fourth  day, 
two  Nux-vom.  4  °  °  on  the  fifth,  and  one  Nux-vom. 4  °  ° 
on  the  seventh,  i.  e.  six  days  from  the  time  of  the 
attack.  The  convalescence  from  the  dysenteric  cho- 
lera commenced  two  days  after  the  attack. 


FEBRILE     CHOLERA. 

CASE  28. — A  married  lady,  aged  about  30,  was 
attacked  in  the  night,  Friday,  Aug.  10th,  1849,  at 
three  o'clock.  Between  three  and  eight,  A.  M.,  had 
five  large,  liquid  stools,  judged  to  be  as  much  as  a 
pint  each  ;  and  the  last  one  chiefly  a  perfectly  serous 
liquid  as  to  consistence,  and  of  a  yellowish  color.  I 
saw  her  at  eight  and  a  half,  A.  M.,  being  called  in 
some  haste.  She  had  taken  five  /loses  of  Tinct. 
Caniph.  gt.  j.  each  ;  and  then,  at  intervals  of  one-half 
hour,  two  of  Verat.  30.  She  was  lying  on  the  sofa  ; 
rather  pale,  yet  felt  "  feverish."  Palms  rather  hot, 
both  in  sensation  and  to  the  touch.  Slight  pain  in 
abdomen,  considerable  in  the  hips  and  limbs  ;  some 
nausea.  The  tongue  slightly  red  at  tip ;  pulse  about 
one  hundred  and  ten ;  thirst  considerable.  Prescribed 


180  CASES  OF  CHOLERA. 

four  doses  Khus-radicans,  including  the  one  admin- 
istered. One  to  be  given  every  two  hours.  Resort 
to  Veratrum80,  if  there  should  be  several  large 
evacuations. 

Five,  P.  M.  lias  had  two  more  evacuations,  thin, 
light-colored,  and  containing  numerous  white  specks. 
Pain  over  the  eyes,  and  in  hips  and  small  of  back. 
Had  taken  Verat.  80,  once. 

R.  Verat.  30,  each  hour,  until  the  evening  visit. 
Improvement  continued  under  Veratrum  80,  which 
was  given  occasionally  next  day,  when  she  was  re- 
corded as  convalescent,  and  on  the  12th  as  recovered. 


A  case  of  Acute  Choleroid  occurred  since  the  above 
was  ready  for  press.  On  Monday,  May  29th,  1854, 
in  the  morning,  a  lady  had  a  stool  of  which  the  first 
part  was  normal,  the  last  half-pint  liquid.  After 
dinner  felt  nausea,  and  a  sensation  of  numbness  in- 
stantly pervading  the  whole  body,  like  an  electric 
shock.  The  lips  and  fingers  soon  became  intensely 
blue,  and  the  latter  strikingly  wrinkled.  The  whole 
disease  disappeared  under  Camph.  30  alone. 

Cases  6,  15  and  16  also  show  the  power  of 
attenuated  Camphor.  If  pellets  of  the  1st,  3d  or 
30th  dilution  supplant  the  tincture,  we  may  avoid 
the  congestions,  which  the  latter  sometimes  occasions, 
also  the  adulteration  of  our  medicines  with  its  vapor. 


CHAPTER    X. 

CHOLERA    REPERTORY. 

CONTAINING  THE  IMPORTANT  SYMPTOMS,  AND  THE  USUAL 
GROUPS,  AND  THE  MEDICINES  TYPOGRAPHICALLY  DIS- 
TINGUISHED AS  TO  THEIR  RELATIVE  VALUE  IN  CHO- 
LERA.* 


EXPLANATION  OF  THE  USE  OF  THE  REPERTORY, 

BELIEVING  that  the  success  of  Homoeopathic  treat- 
ment in  Cholera,  is  such,  that  this  book  will  be  used  by 
many  physicians  who  have  had  but  little,  if  any,  expe- 
rience in  this  kind  of  practice,  as  well  as  by  many  intel- 
ligent laymen,  I  deem  it  proper  to  explain  the  best  mode 
of  using  the  Repertory. 

Select  two  important  symptoms,  of  the  case  to  be  treat- 
ed, and  ascertain  what  remedies  are  common  to  both. 
If  these  are  too  numerous  to  be  retained  in  the  memory, 
write  them  down.  Then  compare  this  reduced  list  with 
the  remedies  as  given  in  the  Repertory  for  some  other 
important  symptom,  and  thus  discover  what  remedies  are 
common  to  the  three.  Then  select  a  fourth,  <fcc.,  and 
continue  this  process  until  there  is  only  one  remedy  left. 
This  will  generally  be  the  remedy  for  the  case,  espe- 
cially if  the  symptoms  selected  are  really  the  most  impor- 
tant. The  method  of  proceeding,  thus  far  described,  is 
the  best  for  all  homoeopathic  repertories,  and  if  faithfully 

*  These  symptoms  and  groups  are  frequently  observed  in  cholera. 

9 


182  CHOLERA   REPERTORY. 

followed  in  reference  to  any  disease,  affords  one  of  the 
best  securities  against  that  name-treating  and  one-symp- 
tom-treating practice,  so  general  among  domestic  pre- 
scribers  and  hasty  physicians. 

In  using  this  method  and  this  Repertory  in  the  treat- 
ment of  Cholera,  it  will  generally  save  labor  to  omit, 
at  every  step  of  the  process,  all  those  medicines  which 
are  not  emphasized  in  at  least  one  of  the  two  lists.  Such 
medicines  will  almost  always  be  eliminated  before  the 
above  process  is  completed.  No  medicine,  which  is 
printed  either  in  small  Roman  letters  or  Italics,  in  every 
place  in  which  it  occurs  in  this  Repertory,  is,  in  the  pre- 
sent state  of  our  knowledge,  known  to  have  much  power 
in  the  first  three  stages  of  non-inflammatory  Cholera  ; 
and  hence  the  use  of  such  medicines,  in  Cholera,  except 
by  a  very  skilful  practitioner,  would  be  unsafe.  If  such 
should  not  all  be  removed  by  the  process  above  described, 
the  only  safe  course  (at  least  for  the  beginner)  would  be, 
to  commence  anews>  and  repeat  the  above  process  with 
other  important  symptoms,  combining  them  with  each 
other  and  with  some  of  those  previously  selected  ;  and  in 
general,  the  making  of  various  combinations  and  in 
various  orders,  will  give  greater  security  in  the  selection 
of  the  remedy.  If  there  are  two  remedies  which  apply 
to  all  the  known  symptoms  of  the  case,  the  selection  may 
be  determined  by  the  type  in  which  their  names  are  here 
printed.  If  the  remedy  is  doubtful,  and  there  is  time  for 
study,  consult  Jahr's  Manual,  especially  the  New. 

One  object  in  the  construction  of  this  Repertory  has 
been  to  save  part  of  the  above  labor,  by  occasionally 
combining  the  symptoms  into  such  groups  (of  two  or 


MENTAL    SYMPTOMS.  183 

three)  as  the  disease  more  frequently  presents.  For  ob- 
taining the  remedies  for  these  groups,  the  Materia  Me- 
dica  of  Hahnemann,  the  Symptomen  Codex  and  various 
Repertories  have  been  consulted.  The  degree  of  em- 
phasis has  been  determined  by  the  clinical  experience  of 
the  school  in  Cholera.  I  have,  however,  italicised  some 
medicines  which  rank  high  for  the  symptom  in  general, 
but  are  not  known  to  be  useful  in  Cholera.  The  em- 
phasis given  to  the  medicines  in  this  Repertory,  has  no 
reference  to  the  4th  stage,  nor  to  the  inflammatory  varie- 
ty, except  where  it  is  so  stated. 

Medicines  seldom  used  in  any  disease  are  omitted; 
also  some  for  vomiting  and  diarrhoea,  seldom  used  in 
Cholera,  and  found  in  Chapter  XI. 

The  concomitant  symptoms  in  any  one  section  of  this 
Repertory,  are  generally  arranged  in  the  same  order  as 
the  sections  themselves.  Where  symptoms,  relating  to 
different  parts  of  the  body,  are  in  the  same  paragraph, 
those  of  the  superior  parts,  are  put  first,  and  the  more 
general  symptoms  last. 

The  paragraphs  are  arranged  alphabetically  ;  but  where 
the  same  symptom,  (as  cramp)  refers  to  different  parts  of 
the  body,  these  parts  are  put  in  the  natural  typographical 
order,  from  above  downwards. 

MENTAL    SYMPTOMS. 

Anguish,  anxiety  or  inquietude:  Aeon.,  ARS.,  bell., 
bry.,  CAMPH.,  CARB.-V.,  cans.,  cham.,  cic.,  coff.,  CUPR., 
dig.,  hyos.,  ign.,  ipec.,  kal.,  lack.,  laur.,  lye.,  mere., 
natr.,  natr.-m.,  nitr.-ac.,  nux,  petr.,  PHOS.,  phos.-ac., 
puls.,  rhus,  SEC.,  sep.,  strain.,  sulph.,  tart.,  VERAT. 


184  CHOLERA    REPERTORY. 

~~ Apathy,  or  indifference  :  Ars.,  bell.,  calc.,  cham., 
chin.,  cic.,  hyos.,  lack.,  lye.,  mere.,  natr.-m.,  phos., 
PHOS.-AC.,  sep.,  staph.  verat. 

Fear  of  Death,  with  internal  Burnings,  and  tossing  in 
the  bed :  ARS. 

Taciturnity,  or  repugnance  to  conversation:  ARS., 
bell.,  bry.,  calc.,  cham.,  cic.,  coloc.,  cupr.,  ign.,  lach., 
mere.,  natr.-m.,  nux,  phos.-ac.,  puls.,  rheum,  stann., 
staph.,  sulph.,  sulph.-ac.,  VERAT. 

HEAD. 

Confusion  in  th^  head :  Aeon.,  ars.,  bell.,  bry.,  calc., 
CAMPH.,  caus.,  chin.,  dig.,  mere.,  nux,  op.,  phos.-ac., 
puls.,  rheum,  rhus,  sec.,  sep.,  sulph.-ac.,  tart.,  VERAT. 

Heaviness,  or  pressure  in  the  head:  Aeon.,  arn.,  ars., 
bell.,  bry.,  calc.,  CAMPH.,  carb.-v.,  cham.,  chin.,  cic., 
dulc.,  ign.,  ipec.,  lack.,  laur.,  lye.,  mere.,  natr.-m.,  nux, 
op.,  petr.,  PHOS.,  PHOS.-AC.,  puls.,  rheum.,  rhus,  sep., 
sil.,  stann.,  sulph.,  tart.,  VERAT. 

Vertigo :  Aeon.,  ant.,  am.,  ars.,  bell.,  bry.,  calc., 
CAMPH.,  carb.-v.,  caus.,  etc.,  cupr.,  dig.,  fer.,  graph., 
hep.,  hyos.,  ign.,  ipec.,  kal.,  lack.,  laur.,  lye.,  mere.,  nat., 
natr.-m.,  nux,  op. ,petr.,  PHOS.,  PHOS.-AC.,  puls., rhus,  SEC., 
sep.,  sil.,  stram.,  sulph.,  sulph.-ac.,  tart.,  thuj.,  VERAT. 

Vertigo  with  nausea  and  thirst :  VERAT. 

Vertigo  with  stupor:  Ars.,  bell.,  bry.,  calc.,  caus.,  kal., 
laur.,  lye.,  mere.,  natr.-m.,  nux,  op.,  PHOS.,  phos.-ac., 
puls.,  rhus,  SEC.,  sil.,  spig.,  stram.,  sulph.,  tart.,  VERAT. 

EYES. 

Eyes  sunk  in  the  orbits  ;  with  livid  semi-circles  under 
them  :  ARS.,  calc.,  camph.,  cic.,  CUPR.,  kal.,  laur.,  PHOS., 
PHOS.-AC.,  SEC.,  sulph  ,  VERAT. 


EYES. — FACE. 


185 


Eyes  sunk  in  the  orbits;  with  hoarse  voice:  ARS., 
calc.,  camph.,  cic.,  CUPR.,  kal.,  laur.,  PHOS.,  phos.-ac., 
SEC.,  sulph.,  VERAT. 

Eyes  Up-turned  and  Fixed :   CAMPH.,  cic.,  VERAT. 

Pupils  contracted :  ARS.,  bell.,  cham.,  CAMPH.,  cicut., 
nux,  puls.,  SECAL.,  sep.,  VERAT. 

FACE. 

Bluish  color  of  the  face  :  Aeon.,  ARS.,  bell.,  bry., 
CAMPH.,  cham.,  cic.,  con.,  CUPR.,  dig.,  dros.,  hep., 
hyos.,  ign.,  ipec.,  lach.,  lye.,  mere.,  op.,  phos,  puls.,  samb., 
spong.,  staph.,  stram.,  tart.,  VERAT. 

Elvish  and  pale  face:  ARS.,  bell.,  bry.,  CAMPH., 
cic.,  con.,  CUPR.,  dig.,  dros.,  hep.,  hyos.,  ign.,  ipec., 
lach.,  lye.,  mere.,  op.,  PROS.,  puls.,  samb.,  spong., 
stram.,  TART.,  VERAT. 

Bluish  color  about  the  Eyes:  ARS.,  calc.,  cham., 
chin,,  CUPR.,  fer.,  graph.,  hep.,  ign.,  ipec.,  kal.,  lach., 
lye.,  mere.,  natr.,  nux,  oleand.,  phos.,  PHOS.-AC.,  rhus, 
sabin.,  SEC.,  sep.,  spig.,  staph  ,  stram.,  sulph.,  VERAT. 

Blueness  of  the  lips  :  Ang.-spur.,  ars.,  camph.  caus., 
berb.,  chin. -sulph ,  cupr.,  dig.,  lye.,  phos. 

Blueness  of  the  lips,  with  corrugated  and  withered 
appearance  of  the  skin:  ARS.,  CAMPH.,  CUPR.,  lye.,  phos. 

Blueness  under  Eyes  :  Sleeps  with  eyes  open:  Ipec., 
PHOS. -AC.,  sulph.,  VERAT. 

Blueness  of  the  face  and  lips  ;  Coldness  of  the  lips : 
ARS.,  cupr.,  VERAT. 

Blueness  of  the  face  ;  vomiting  after  drinking;  pulse 
slow  ;  sweat  clammy  :  VERAT. 


186  CHOLERA    REPERTORY. 

Cold  Perspiration  on  the  face  :  Carb.-v.,  rheum.,  nux, 
rhus,  verat. 

Cold  perspiration  on  the  forehead  during  the  evacua- 
tion: VERAT. 

Cold  Perspiration  on  the  Face  and  Limbs:  CARB.-V. 
•    Coldness  of  the  nose  :  Am.,  bell.,  plumb.,  verat. 

Coldness  of  the  nose  and  hands  :  Bell.,  VERAT. 

Fades  cholerica  :  ARS.,  camph.,  carb.-v.,  CUPR.,  ipec., 
laur.,  phos.,  phos.-ac.,  rhus,  SEC.,  VERAT. 

Face  choleric  ;  Voice  hoarse  :  ARS.,  camph.,  CARB.-V., 
CUPR.,  latir.,  PHOS.,  phos.-ac. ,  rhus,  sec.  VERAT. 

Spasm  of  the  Jaw :  Bell.,  cham.,  CAMPH.,  cicut., 
CUPR.,  hydrocy.,  lach.,  laur.,  op.,  rhus,  SEC.,  VERAT. 

TONGUE. 

Coats  on  the  Tongue . 

Brown  :  Bell.,  CARB.-V.,  hyos.,  PHOS.,  rhus-rad., 
sabin.,  sulph. 

Mucous  :  Bell.,  cupr.,  dulc.,  lach.,  mere.,  PHOS.-AC. 
puls.,  sulph. 

Viscid:  PHOS.-AC. 

White:  Ant.,  arn.,  bell.,  bry.,  calc.  carb.-v.,  cupr., 
dig.,  ign..  ipec.,  mere.,  nitr.,  nux,  petr.,  puls.,  sabin.,  sec., 
sep.,  sulph. 

Yellowish:  Bell.,  bry.,  carb.-v.,  cham.,  chin.,  coloc., 
IPEC.,  nux,  plumb.,  puls.,  rhus-rad.,  verat. 

Coldness  of  the  tongue :  Ars.,  bell.,  camph.,  laur., 
natr.-m.,  sec.,  VERAT. 

Coldness  of  the  tongue  and  breath:  ARS.,  CARB.-V.. 
camph.,  VERAT. 


NAUSEA.  AND  THIRST. — VOMITING.  187 

Coldness  of  the  tongue,  with  dryness  of  it  and  of  the 
mouth  :  ARS.,  bell.,  camph.,  laur.,  SEC.,  VERAT. 

Coldness  of  the  tongue,  with  cold  sweat  on  the  body  : 
Ars.,  CAMPH.,  sec.,  VERAT. 

The  same  symptoms  in  a  more  advanced  state  of 
collapse  :  ARS.,  camph.,  carb.-v.,  CCPR.,  SEC.,  VERAT. 

Redness  of  the  tongue:  Ars.,  bell.,  bry.,  chain.,  hyos., 
lach.,  mix,  rhus,  stann.,  sulph.,  verat. 

Redness  of  the  tip  of  the  tongue,  in  the  febrile 
variety,  or  in  the  4th  stage :  RHUS-RAD. 

Tongue  Red,  and  coated  yellow:  Bry.,  cham.,  nux, 
r.-rad.,  VERAT. 

Tongue  Red ;    Pulse  Slow:    Bell ,  rhus-rad.  VERAT. 

NAUSEA   AND   THIRST. 

Nausea  with  thirst:  Bell.,  PHOS.,  VERAT. 

Nausea  with  vertigo  :  CAMPH.,  mere.,  verat. 

Nausea  with  continued  pain  at  the  pit  of  the  stomach: 
Aeon.,  ARS.,  bell.,  CAMPH.,  cham.,  CUPR.,  mere.,  natr.-m., 
nux,  PHOS.,  puls.,  rhus,  sulph.,  tart ,  VERAT. 

Nausea  with  diarrhoea:  Ars.,  ipec.,  mere.,  PHOS. 

Thirst,  violent:  Aeon.,  ARS.,  bry.,  CAMPH.,  CARB.-V., 
cham.,  cic.,  CUPR.,  ipec.,  laur.,  mere.,  natr.-m.,  nux,  phos  , 
phos.-ac.,  SEC.,  stram.,  VERAT. 

Thirst,  with  nausea  :  PHOS.,  VERAT. 

VOMITING  . 

Vomiting  after  a  meal ;  blueness  of  the  lips :  ARS., 
phos 

Vomiting  after  drinking ;  with  blueness  of  the  face  : 
ARS.,  VERAT. 


188  CHOLERA  REPERTORY. 

r~~ 

Vomiting  after  drinking:  Am.,   ARS.,  bry.,  nux,  puls., 

VERAT. 

Vomiting  frothy:  VERAT. 

Vomiting  of  a  watery  liquid,  analogous  to  that  of  the 
stools,  with  pieces  of  mucus:  ARS.,  bell.,  camph.,  CUPR., 
JATROPH.,  sec.,  IPEC.,  stram.,  VERAT. 

Vomiting  with  pain  in  the  stomach  :  ARS.,  bry.,  camph., 
C.UPR.,  IPEC.,  lach.,  nux,  PHOS.,  sulph.,  stram.,  tart., 
VERAT. 

Vomiting  with  Colic:  Ars.,  CUPR.,  nux,  PHOS.,  puls., 
stram.,  tart.,  VERAT. 

Vomiting  with  diarrhoea :  Ars.,  cupr.,  jat.,  IpEC.,phos., 
sec.,  stram.,  tart.,  VERAT. 

Vomiting  with  Colic  and  Diarrhoea :  ARS.,  CUPR.,  PHOS., 
stram.,  tart.,  VERAT. 

Vomiting  with  lassitude :  Ars.,  camph.,  IPEC.,  phos., 
VERAT. 

PAINFUL    SENSATIONS    AT    THE    STOMACH 
AND    PIT    OF    THE     STOMACH. 

Anxiety,  distension  and  pressure  at  the  pit  of  the 
stomach:  ARS. 

Burning  in  the  stomach  :  ARS.,  bell.,  bry.,  camph., 
canth.,  CARB.-V.,  cham.,  cic.,  jat.,  laur.,  mere.,  nux, 
PHOS.,  phos.-ac.,  SEC.,  verat. 

Burning  in  the  pit  of  the  stomach  :    Aeon.,  ARS.,  bell., 
bry.,  laur.,  mere.,  nux,  PHOS.,  sec.,  VERAT. 
1    Burning  Heat  in  the  stomach  or  pit  of  stomach  :  ARS., 
CAMPH.,  HYDROC.,  PHOS. 

Burning  sensation  in  the  stomach  and  intestines,  some- 
times extending  along  the  oesophagus  to  the  mouth  :  ARS. 


ABDOMEN.  189 


Cramp  in  the  stomach  :  Bell,  bry.,  carb.-v.,  cham., 
CUPR.,  natr.-m.,  nux,  PHOS.,  SEC.,  VERAT. 

Pressure  and  Anxiety  at  the  pit  of  the  stomach  :  ARS., 
CAMPH.,  cupr.,  IPEC  ,  NUX-VOM.,  verat. 

Continued  Pain  at  the  pit  of  the  stomach  with  nausea  : 
Aeon.,  ARS.,belL,  CAMPH.,  cham.,  CUPR.,  mere.,  natr.-m., 
nux,  PHOS.,  rhus,  sulph.,  tart.,  VERAT. 

Pain  in  the  stomach,  with  vomiting:  ARS.,  camph., 
CUPR,,  IPEC.,  PHOS.,  TART.,  VERAT. 

Continued  Pain  in  the  pit  of  the  Stomach  with  Rumb- 
lings in  the  intestines  :  Aeon.,  ars.,  bell.,  camph.,  CARB.-V., 
CUPR.,  jatroph.,  mere.,  natr.-m.,  nux,  PHOS.,  PHOS.-AC., 
puls.,  rhus,  SEC.,  sulph.,  tart-,  VERAT. 

Pressive  or  aching  pain  at  the  pit  of  the  stomach  with 
liquid  stools :  Ars.,  CAMPH.,  cupr.,  PHOS.,  sec.,  tart., 
VERAT. 

Pressive  or  aching  pain  at  the  pit  of  the  stomach,  with 
cramps  or  other  spasms  in  the  extremities  or  elsewhere  : 
CAMPH- ,  CUPR.,  phos-,  phos.-ac.,  natr.-m.,  sec.,  tart., 
VERAT. 

Sensibility  and  Swelling  of  the  pit  of  the  stomach : 
Hep.,  lye.,  natr.-m.,  sulph. 

Painful  sensibility  of  the  pit  of  the  stomach,  with  spasms 
of  the  extremities:  Ars.,  CAMPH.,  CUPR.,  natr.-m. , phos., 
phos.-ac.,  tart.,  VERAT. 

ABDOMEN. 

Pains  in  the  abdomen,  with  diarrhoea :  ARS.,  cham., 
IPEC.,  laur.,  mere.,  merc.-c.,  natr.-m.,  nux,  phos.,  rhus, 
stram.,  sulph.,  tart.,  VERAT. 


190  CHOLERA    REPERTORY. 


Rumblings  in  the  intestines  :  Aeon.,  ars.,  bell.,  bry., 
canth.,CARB.-v.,cupr.,  jatroph.,  laur.,  lye.,  mere.,  natr.-in., 
nux,  PHOS.,  PHOS.-AC.,  plumb.,  puls.,  rhus,  sec.,  strain., 
sulph.,  tart.,  VBRAT. 

Rumblings  in  the  intestines,  with  continued  pain  in  the 
pit  of  the  Stomach:  Aeon.,  ars.,  bell.,  camph.,  CARB.-V., 
CUPR.,  jatroph.,  mere.,  natr.-m.,  nux,  PHOS.,  PHOS.-AC., 
puls.,  rhus,  SEC.,  sulph.,  tart.,  VERAT. 

Rumblings  in  the  intestines,  with  liquid  stools  :  Ars., 
jatroph.,  nux,  petr.,  PHOS.,  PHOS.-AC.,  puls.,  rhus,  sec., 
sulph.,  tart ,  VERAT. 

Throbbings  in  the  abdomen  :  Caps.,  ign.,  op.,  plumb., 
sang.,  tart. 

DIARRHOEA. 

Diarrhoea,  with  a  pasty  tongue,  which  sticks  to  the 
fingers:  PHOS.-AC. 

Diarrhoea  with  nausea:  Ars.,  ipec.,  mere.,  PHOS. 

Diarrhoea  with  vomitings:  Ars.,  cupr.,  jat.,  IPEC., 
PHOS.,  stram.,  tart.,  VERAT. 

Diarrhoea,  with  vomiting  of  the  Food  eaten,  and  of  wa- 
tery liquid  :  ARS.,  CUPR.,  IPEC.,  PHOS.,  VERAT. 

Diarrhoea,  with  aching  or  pressure,  at  or  near  the  pit 
of  the  Stomach:  CAMPH.,  cham.,  CUPR.,  mere.,  natr.-m., 
PHOS.,  PHOS.-AC.,  sec.,  VERAT. 

Diarrhoea, with  pain  in  the  Abdomen:  A.v.s.,cham.,  ipec., 
laur.,  mere.,  merc.-c.,  natr.-m.,  phos.,  stram.,  sulph.,  tart., 
VERAT. 

Diarrhoea,  occasioning  great  Prostration  of  strength : 
ARS.,  bry.,  cAm.,  con.,  mere.,  PHOS.,  rheum,  SECAL., 
sep.,  sulph. 


DIARRHCEA. 


191 


Diarrh&a  occasioning  great  prostration  of  strength,  in 
Aged  persons  :  Con.,  SEGAL. 

Stools  brown  :  Ars.,  CAMPH.,  merc.-c.,  sulph.,  tart., 
VERAT. 

Stools  greenish:  ARS.,  bell.,  canth.,  cham.,  ipec., 
laur.,  mere.,  nux,  PHOS.,  PHOS.-AC.,  sulph.,  VERAT. 

Stools  grey,  or  slightly  whitish :  Aeon.,  ars.,  bell., 
carb.-v.,  cham.,  lach.,  mere.,  PHOS.,  PHOS.-AC.,  puls., 
rhus,  sulph.,  verat. 

Stools  liquid :  Arn.,  ars-,  carb.-v.,  chin.,  cic.,jat.,  lach., 
meph.,  PHOS.,  PHOS.-AC.,  SEC.,  VERAT. 

Stools  liquid  and  whitish :  Ars.,  camph.,  cupr.,  jat., 
PHOS.,  PHOS.-AC.,  sec.,  VERAT. 

Liquid  and  whitish  stools,  with  white  coat  of  tongue  : 
Cupr.,  PHOS.,  SEC. 

Liquid  stools,  with  continued  pain  at  the  pit  of  the 
stomach:  Ars.,  CAMPH.,  chin.,  cupr.,  PHOS.,  VERAT. 

Liquid  stools,  with  rumblings  in  the  intestines :  Ars,, 
jat.,  nux,  petr.,  PHOS.,  PHOS.-AC.,  puls.,  rhus,  sec., 
sulph.,  tart.,  VERAT. 

Stools  liquid  ;  evacuation  painful,  (attended  with  colic)  : 
ARS.,  carb.-v;  PHOS.,  spig.,  staph.,  VERAT. 

IStools  liquid ;  evacuation  painless :  ARS.,  carb.-v., 
chin.,  cic.,  PHOS.,  PHOS.-AC.,  SEC.,  spig.,  VERAT. 

Stools  mucous  and  watery:  Ars.,  bell.,  chin.,  ipec.,  nux, 
PHOS.,  PHOS.-AC.,  puls.,  rhus,  SEC.,  sulph.-ac.,  tart., 
VERAT. 

Rice-water  stools,  or  stools  like  whey  or  water,  with 
whitish  or  greyish  flocks  in  it :  Ars.,  CAMPH,  cupr.,  ipec., 
jat.,  PHOS.,  PHOS.-AC.,  secal.,  VERAT.  If  there  is 
inflammation,  consult  also,  Aeon.,  bry.,  and  rhus. 


192  CHOLERA    REPERTORY. 

Rice-water  stools,  or  watery,  greyish,  whitish  and  floc- 
culent  stools,  with  great  thirst :  ARS.,  carnph.,  cupr.,  ipec., 
PHOS.,  PHOS.-AC.,  VERAT.  If  in  the  febrile  variety,  or  in 
the  4th  stage  :  Aeon.,  bry.,  or  rhus. 

Stools  whitish :  Aeon.,  ars.,  camph.,  bell.,  c ham.,  chin., 
cupr.,  ipec.,  jat.,  mere.,  nux,  PHOS.,  PHOS.-AC.,  sec., 
sulph.,  verat. 

Watery  and  white  flocky  stools,  with  cramps  and  thirst  : 
Aeon.,  ars.t  bry.,  CAMPR.,  CUPR.,  ipec.  phos.,  phos.-ac., 
rhus,  SEC.,  VERAT. 

Watery  and  white-flocky  stools,  with  clonic  spasms: 
(spasmodic  movements)  and  thirst:  Aeon.,  ARS.,  bry., 
CAMPH.,  CUPR.,  ipec.,  phos.,  phos.-ac.,  SEC.,  VERAT. 

Whitish  Flocks  in  serous  stools,  with  pulse  scarcely 
perceptible:  Aeon.,  ARS.,  bry.,  CAMPH.,  PHOS. -AC.,  rhus, 
SEC.,  VERAT. 

Liquid  stools,  with  white  flocks  and  grains,  having  the 
consistence  and  color  of  tallow :  PHOS. 

Stools  yellowish:  Ars.,  cham.,  ipec.,  mere.,  PHOS., 
PHOS.-AC.,  puls.,  tart.,  verat. 

Yellowish  stools,  especially  in  an  early  stage  of  the 
disease:  Ars.,  cham.,  ipec.,  mere.,  PHOS.,  PHOS.-AC., 
tart.,  VERAT. 

URINE. 

Retention  of  urine  :  CAMPH.,  CANTH.,  lach.,op.,  plumb., 
VERAT. 

Retention  of  Urine,  with  ineffectual  desire  to  urinate  ; 
at  the  commencement  of  the  stage  of  reaction:  CANTH., 
verat. 


VOICE. CHEST.  193 


Urine  scantily  secreted,  or  suppressed  :  Ars.,  camph., 
CARB.-V  ,  CUPR.,  ipec.,  SEC.,  stram.,  VERAT. 

The  same  symptom  in  the  consecutive  fever  :  BELL., 
carb.-v.,  RHUS,  stram. 

Secretion  of  urine  diminished ;  with  cramps  in  the 
calves  of  the  legs  :  ARS.,  calc..  CAMPH.,  cann.,  carb^-v., 
coff.,  coloc.,  con.,  CUPR.,  graph.,  hyos.,  lach.,  lye., 
mere.,  natr.,  nux,  petr.,  rhus,  sec.,  sep.,  sil.,  sulph., 
VERAT. 

VOICE. 

Voice  hoarse:  ARS.,  bell.,  bry.,  calc.,  camph.,  CARB.- 
V.,  caus.,  cham.,  chin.,  etc.,  CUPR.,  dros.,  graph., 
hep.,  laur.,  mere.,  natr.-m.,  nux,  PHOS.,  phos.-ac.,  puls., 
rhus,  sec.,  spong.,  sulph.,  VERAT. 

Voice  hoarse  ;  face  choleric  :  ARS.,  camph.,  CARB.-V., 
CUPR.,  laur.,  PHOS., phos.-ac.,  rhus,  SEC.,  VERAT. 

Voice  lost,  (aphonia) :  Ant.,  bell.,  CARB.-V.,  caus., 
cham.,  chin.,  CUPR.,  dros.,  hep.,  kal.,  lach.,  laur., 
mere.,  natr.-m.,  nux,  petr.,  PROS.,  puls.,  sep.,  sil., 
spong.,  stann.,  sulph.,  VERAT. 

CHEST. 

Anguish  in  the  chest :  Aeon.,  ARS.,  bell.,  bry.,  camph., 
carb.-v.,  cic.,  CUPR  ,  hydrocyan.,  ipec.,  jatroph.,  laur., 
natr.-m.,  phos.,  PHOS.-AC.,  rhus,  stram.,  VERAT. 

Breath  cold:  CARB.-V.  And,  according  to  some 
clinical  observations,  ars.,  camph.,  verat. 

Constriction  (spasmodic)  of  the  chest :  CAMPH.,  caus., 
CUPR.,  fer.,  IPEC.,  lach.,  nitr.-ac.,  nux,  op.,  PROS.,  phos.- 
ac.,  puls.,  spig.,  stram.,  sulph.,  VERAT. 


194  CHOLERA    REPERTORY. 

Cramps  or  tonic  spasms  in  the  chest :  Ars.,  bell., 
CAMPH.,  caus.,  CIC.,  CUPR.,  fer.,  graph.,  hyos.,  IPEC., 
kal.,  mere.,  nux,  op.,  PHOS.,  phos.-ac.,  puls.,  SEC.,  sep., 
stram.,  sulph.,  VERAT. 

Cramps  in  the  muscles  of  the  chest,  with  continual 
vomitings,  and  with  the  eyes  turned  upwards:  CAMPH., 
CIC.,  VERAT. 

Respiration  laborious ;  cold  and  blue  skin :  ARS., 
CAMPH.,  CARB.-V.,  CUPR.,  ipec.,  sec.,  VERAT. 

SUPERIOR     EXTREMITIES.    • 

Cramps  in  the  upper  arms  :  Phos.-ac.,  SEC. 

Cramps  in  the  forearms  :  Laur.,  phos.-ac. ,  SEC. 

Cramps  in  the  ivrist  :  Phos-ac. 

Coldness  of  the  hands :  Aeon.,  bell.,  cham.,  ipec.,  natr.~ 
m.,  nux,  petr.,  phos.,  sulph.,  tart.,  VERAT. 

Cramps  in  the  hands  :  Bell.,  calc.,  cann.,  coloc.,  graph., 
laur.,  phos-ac.,  SEC.,  strara. 

Cramps  in  the  fingers :  Am.,  ars.,  calc.,  cann.,  coff., 
dros.,  fer.,  lye.,  nux, phos., phos.-ac.,  SEC.,  stann.  staph., 
sulph.,  VERAT. 

Cramps  in  the  fingers,  with  clamminess  of  the  tongue 
and  skin  :  PHOS-AC. 

Cramps  in  the  fingers,  with  clammy  perspiration : 
Ars.,  fer.,  lye.,  nux,  phos.,  phos-ac.,  VERAT. 

INFERIOR  EXTREMITIES. 

Coldness  of  the  feet :  Aeon.,  bell.,  calc.,  caus.,  dig., 
graph.,  ipec.,  kal.,  lach.,  lye.,  mere.,  natr.,  natr.-m., 
nitr.-ac.,  petr.,  PHOS.,  plat.,  plumb.,  rhod.,  rhus-rad., 
sep.,  sil.,  sulph.,  tart.,  VERAT. 

Cramps  in  the  nates :  VERAT. 


SKIN.  195 

Cramps  in  the  hips:   Coloc.,  phos-ac. 

Cramps   in  the   thighs:  CAMPH.,    cann.,   hyos.    ipec., 
mere.,  petr.,  phos.-ac.,  rhus,  sep.,  VERAT. 
Cramps  in  the  hams  :    Calc.,  cann.,  phos. 

Cramps  in  the  legs :  Carb.-v.,  coloc.,  CUPR.,  JAT., 
phos.-ac. 

Cramps  in  the  calves  of  the  legs  :  Ars.,  bry.,  calc., 
CAMPH.,  cann.,  carb.-v.,  cham.,  coff.,  coloc.,  CUPR., 
graph.,  hyos.,  JAT.,  lach.,  lye.,  merc.,natr.,  nitr.-ac.,  nux, 
petr.,  PHOS.,  rhus,  sec.,  sep.,  sil.,  sol.-n.,  staph.,  sulph.,  tart,, 
VERAT. 

Cramps  in  the  calves  of  the  legs,  with  burning  heat  in 
the  stomach,  or  pit  of  stomach :  ARS.,  CAMPH..  PHOS. 

Cramps  in  the  calves  of  the  legs,  with  diminished  se- 
cretion of  urine  :  Ars.,  calc.,  CAMPH.,  cann.,,  carb.-v., 
coff.,  coloc.,  CUPR.,  graph.,  hyos.,  lach.,  lye.,  magn., 
mere.,  na^r.,  mix,  petr.,  rhus,  sec.,  sep.,  sil.,  staph.,  sulph., 
VERAT. 

Cramps  in  the  calves;  coldness  of  the  feet:  Calc., 
graph.,  lach.,  lye.,  mere.,  natr.,  nitr.,  ac.,  petr. ,  PHOS.,  rhus- 
rad.,  sep.,  sil.,  sulph.,  tart.,  VERAT. 

Cramps  in  the  feel:  CAMPH.,  caus.,  graph.,  lye., 
natr.,  nux,  sec.,  stram.,  sulph. 

Cramps  in  the  feet,  with  burning  in  the  stomach,  or  pit 
of  stomach:  CAMPH. 

Cramps  in  the  soles  of  the  feet:  Calc.,  carb.-v.,  coff., 
fer.,  hep.,  petr.,  phos.-ac.,  plumb.,  sec.,  sil.,  staph.,  sulph. 

Cramps  in  the  toes :  Calc.,  fer.,  hep.,  lye.,  mere.,  nux, 
phos.-ac.,  SEC.,  sulph. 

SKIN. 
.   Blueness   of  the   skin :  Aeon.,   am.,   ARS.,   bell.,  bry., 


196  CHOLERA      REPERTORY. 

calc.,  camph.,  CARB.-V.,  CUPR.,  dig.,  lack.,  mere.,  natr.-m., 
nux,  op.,  phos.,  phos.-ac.,  plumb.,  puls.,  rhus,  SEC.,  sil., 
spong.,  thuj.,  VERAT. 

Blueness  of  the  skin  in  different  parts,  and  withered  ap- 
pearance of  it:  ARS.,  bry.,  calc.,  CAMPH.,  CUPR.,  mere., 
nux,  phos.,  phos.-ac.,  SECAL.,  sil.,  spong.,  VERAT. 

Coldness  of  the  skin  :  Aeon.,  ant.,  am.,  ars.,  bell.,  bry., 
calc.,  CAMPH.,  cann.,  canth.,  CARB.-V.,  caus.,  cham.,  chin., 
cic.,  cupr.,  dros.,  dulc.,  fer.,  graph.,  hell.,  hep.,  hyos.,  ign., 
IPEC.,  kal..  Inch.,  laur.,  lye.,  mere.,  mez.,  natr.,  natr.-m., 
nitr.-ac.,  nux,  op.,  petr.,  PHOS.,  phos.-ac.,  plumb.,  puls., 
rhus,  sabad.,  sabin.,  sec.,  sep.,  sil.,  spig.,  spong.,  stann., 
staph.,  stram.,  sulph.,  tart.,  thuj.,  VERAT. 

The  medicines  which  correspond  both  to  coldness  and 
blueness  (of  the  skin),  respectively  or  collectively,  are : 
Aeon.,  arn.,  ARS.,  bell.,  bry.,  calc.,  CAMPH.,  CARB.-T., 
CUPR.,  lack.,  mere.,  natr.-m.,  nux,  op.,  PHOS.,  PHOS.-AC., 
plumb.,  puls.,  rhus,  SEC.,  sil ,  spong.,  thuj  ,  VERAT. 

Skin  cold  and  bluish,  and  covered  with  cold  perspira- 
tion: ARS.,  camph.,  carb.-v.,  CUPR.,  ipec.,  SECAL.,  VE- 
RAT. 

Coldness  of  the  skin,  with  mental  indifference  or  tran- 
quillity: ARS.,  ipec.,  NATR.-M.,  VERAT. 

Withered  or  wrinkled  skin  :  Ant.,  ARS.,  bry.,  cole., 
camph.,  cham.,  chin.,  CUPR.,  fer.,  graph.,  hell.,  hyos.,  iod., 
kal.,  lye.,  mere.,  mur.-ac.,  nux,  phos.,  PHOS.-AC.,  rheum., 
SEC.,  sep.,  sil.,  spig.,  spong.,  strain.,  sulph.,  VERAT. 

The  medicines  which  correspond,  respectively  or  col- 
lectively, to  blueness,  coldness,  and  shrivelled  state  of  the 
skin,  are:  ARS.,  bry.,  calc.,  CAMPH.,  CUPR.,  mere.,  nux, 
PHOS.,  PHOS.-AC.,  SEC.,  sil.,  spong.,  VERAT. 


PERSPIRATION     AND     PULSE.  197 

The  medicines  which,  on  the  ground  of  clinical  experi- 
ence, have  been  more  especially  recommended  for  this 
combination  of  symptoms,  in  the  stage  of  collapse  in  cho- 
lera, are:  ARS.,  CAMPH.,  CAKB.-V.,  CUPH.,  hydrocy., 
jat.,  SEC.,  VERAT. 

PERSPIRATION    AND     PULSE. 

Perspiration,  cold:  Aeon.,  ARS,  bell.,  bry.,  calc., 
CAMPH.,  canth.,  CARB.-T.,  cham.,  chin.,  cin.,  cofF.,  CUPR., 
dulc.,  hell.,  hep.,  hyos.,  ign.,  IPKC.,  lach.,  lye.,  mere., 
natr.,  nitr.-ac.,  nux,  op.,  petr.,  phos.,  phos.-ac.,  plumb., 
puls.,  rheum.,  rhus,  sabad  ,  SEC.,  sep.,  sil.,  spig.,  stram., 
sulph  ,  thuj.,  tart.,  VERAT. 

Perspiration,  viscid,  clammy  :  ARS.,  camph.,  daph.,  fer., 
hep.,  jat.,  lach.,  lye.,  mere.,  nux,  phos.,  phos.-ac.,  plumb., 
sec.,  VERAT. 

Perspiration  clammy,  with  slow  pulse  :  CAMPH.,  mere., 
VERAT. 

Perspiration  clammy,  with  spasmodic  movements  o£ 
the  jaw  :  CAMPH.,  mere.,  nux,  phos.,  plumb.,  SEC.  VE- 
RAT. 

Pulse  feeble  and  frequent :  Ars.,  CARB.-V.,  lach.,  nux, 
rhus-rad. 

Pulse  Feeble  and  Slow,  in  the  1st  stage :  CAMPH., 
cann.,  dig.,  LAUR.,  mere.,  puls.,  rhus.-rad.,  VERAT. 

Pulse  Feeble  and  Slow,  in  the  4th  stage ;  Camph.,  cann., 
dig.,  laur.,  mere.,  puls.,  R.-RAD.,  VERAT. 

Pulse  feeble  and  small:  ARS.,  CAMPH.,  chin.,  dig., 
LACH.,  nux,  PHOS.-AC.,  puls.,  RHUS,  VERAT. 

Pulse  scarcely  perceptible,  with  watery  and  white-flocky 
stools:  Aeon.,  ARS.,  bry.,  CAMPH.,  PHOS.-AC,,  rhus,  SEC., 
VERAT. 


198  CHOLERA    REPERTORY. 

GENERAL    AND    MISCELLANEOUS    SYMPTOMS. 

Burning  internally,  and  tossing,  with  fear  of  death  : 
ARS. 

Burnings  in  the  stomach  and  abdomen,  with  anguish  and 
tossing:  ARS.,  CAMPH. 

Cholera  followed  by  cerebral  and  abdominal  affections  : 
BELL. 

Collapse  so  complete,  that  no  vomiting,  diarrhoea,  or 
spasms  remain,  though  some  or  all  of  them  have  existed 
previously;  ARS.,  camph.,  CARB.-V.,  CUPR.,  HYDRO- 
CY.,  laur.,  verat. 

Collapse,  without  previous  or  present  vomiting,  or  diar- 
rhoea:  CAMPH.,  CARV.-v.,.hydrocy.,  laur.,  VERAT. 

Cramps  or  other  Spasms  at  night :  Ars.,  camph.,  calc., 
cin.,  CUPR.,  hyos.,  ipec.,  kal.,  lye.,  mere.,  op.,  SEC. 

Cramps  in  the  stomach  and  extremities,  with  coldness  of 
the  body  in  an  early  stage,  with  but  little  diarrhoea : 
CAMPH. 

Spasms,  Clonic,  (convulsions) :  Ars.,  bell.,  bry.,  calc., 
CAMPH.,  canth  ,  carb.-v.,  caus.,  cham.,  cic.,  con.,  CUPR., 
hyos.,  ign.,  ipec.,  cal.,  lye.,  mere.,  natr.-m.,  op.,  phos., 
phos.-ac.,  plat.,  rhus,  SEC.,  sep  ,  sil.,stann.,  STRAM.,  tart., 
sulph.,  VERAT. 

Spasms,  severe  and  clonic,  with  but  little  diarrhoea  or 
vomiting:  Ars.,  CAMPH.,  CUPR.,  ipec.,  sec.,  VERAT. 

Spasms,  Tonic,  (Tetanus,  Cramps,  &c.) :  Ars.,  bell., 
caus.,  cham.,  Cic.,  CUPR.,  ign.,  ipec.,  lye.,  mere.,  petr., 
phos.,  plat.,  rhus,  SEC.,  sep.,  stram.,  sulph.,  VERAT. 

Spasms,  severe  and  tonic,  with  but  little  diarrhoea  or 
vomiting  :  CAMPH.,  CUPR.,  ipec.,  SEC.,  VERAT. 


GENERAL  AND  MISCELLANEOUS  SYMPTOMS.  199 

Spasms  or  Cramps,  in  the  extremities  or  elsewhere,  with 
weight,  pressire  pain  or  aching,  at  the  pit  of  the  stomach  : 
CAMPH.,  CUPR.,  natr.-m.,  phos.,  phos.-ac.,  sec.,  tart.,  VE- 
RAT. 

Spasms  of  the  extremities,  with  painful  sensibility  of 
the  pit  of  the  stomach:  Ars.,  CAMPH.,  CUPR.,  natr.-m., 
phos.,  phos.-ac.,  tart.,  VERAT. 

Spasms  return  at  night :    Cuprum,  SECALE. 

Excessive  and  sudden  debility:  Ars.,  carb.-v.,  ^CUPR., 
ipcc.,  lach.,  laitr.,  nux,  PHOS.,  PHOS.-AC.,  sec.,  VERAT. 

The  patient  worse  after  midnight,  or  early  in  the  morn- 
ing :  Aeon.,  ARS.,  bell.,  canth.,  CARB.-V.,  CUPR.,  kal., 
lach.,  mere.,  natr.,  natr.-m.,  nux,  petr.,  PHOS.,  PHOS.-AC., 
RHUS,  sec.,  stram.,  sulph.,  tart.,  VERAT. 

The  patient  made  worse  by  movement :  Aeon.,  ARS. 
BELL.,  bry.,  CAMPH.,  canth.,  carb.-v.,  cic.,  CUPR.,  dig., 
hyos.,  IPEC.,  kal.,  lach.,  laur.,  mere.,  natr.-m.,  nux,  petr., 
PHOS.,  PHOS.-AC.,  plumb.,  rhus,  rod.,  SEC.,  stram.,  sulph., 
tart.,  VERAT. 

CHAPTER   XI. 

GASTRIC   AND    INTESTINAL    REPERTORY.* 

AUXILIARY  TO  THE  CHOLERA  REPERTORY,  AND  ADAPTED  ALSO 
TO  VOMITING  AND  DIARRHfEA  IN  GENERAL,  AND  TO  CHOLERA 
INFANTUM  AND  DYSENTERY. 


EXPLANATION   OF   THE    USE    OF   THE    REPERTORY. 
THE  arrangement  of  the  symptoms  of  each  section,  is 
in  general  alphabetical. 

*  Taken  chiefly  from  Jahr's  excellent  Manual,  with  some  modifi- 
cations. 


200  CHOLERA    KKPRRTORY. 

The  mode  of  obtaining  the  remedy  for  a  group,  is  the 
same  in  this,  as  in  the  Cholera  Repertory.  The  medi- 
cines seldom  required,  are  here  omitted.  The  emphasis 
in  Chapter  XL,  has  no  special  reference  to  Cholera;  but 
in  the  treatment  of  this  disease,  this  chapter  may  be  con- 
sulted, when  any  case  presents  symptoms  contained  in 
this,  but  not  in  the  Cholera  Repertory;  and  that  Reper- 
tory may  be  used  as  auxiliary  to  this  and  in  general  prac- 
tice ;  for  the  medicines  there  enumerated  apply  to  the 
symptoms,  in  whatever  disease  they  may  occur. 

The  30th,  will  in  general  be  a  suitable  dilution  for  most 
medicines,  in  ordinary  gastric  and  intestinal  diseases,  for 
which  this  Repertory  (Chap.  XI,)  is  more  especially  con- 
structed. 

VOMITING  IN  GENERAL. 
Aeon.,  ant.,  am.,  ars.,  bell.,  bry.,  calc.,  camph.,  cann., 
canth.,  carb.-v.,  cham.,  chin.,  cic.,  cin.,  coff.,  colch.,  coloc., 
cupr.j  dros.,  dulc.,  fer.,  graph.,  hep.,  hyos.,  ign.,  ipec., 
lach.,  laur.,  lye.,  mere.,  natr.-m.,  nitr.-ac..  nux,  phos., 
plumb.,  puls.,  sec.,  sep.,  *t7.,  stann.,  stram.,  sulph  ,  tart., 
verat. 

CHARACTER    OF    THE   VOMITING. 
Vomiting :  Acrid :  Arg.,  ipec. 

Bilious,  bitter:    Aeon.,  ant.,  ars.,  bry.,  camph., 

cann.,  colch,,  cupr.,  dros.,  grat.,  ipec.,  lach.,  mere.,  nux., 
phos.,  puls.,  sec.,  sep.,  stann.,  stram.,  sulph.,  verat, 

Bitterish-Sour  :  Grat.,  ipec.,  puls. 

Blackish  :    Ars.,    calc.,   chin.,   hell.,  laur.,  nux, 

phoV,  plumb.,  sec.,  sulph.,  verat. 

of  Blood:    Aeon.,   am.,   ars.,   bell.,   bry.,  calc., 


CHARACTER   OF    THE    VOMITING.  201 

camph.,  canth.,  carb.-v.t  caus.,  chin.,  cupr.,  dros.,  fer., 
hep.,  hyos.,  lack.,  lye.,  mez.,  nux,  op.,  phos.,  plumb.,  puls., 
sulph.,  verat.,  zinc. 

of  Blood  clotted:  Am.,  caus. 

Vomiting  of  Blood;  sour  regurgitations :  Ars.,  calc., 
carb.-v.,  lye.,  nux,  phos.,  plumb.,  puls.,  sulph. 

Vomiting  Brownish  :   Ars.,  bis. 

Vomiting  of  what  has  been  drank:  Aeon.,  ant.,  arn., 
,ars.,  bry.,  cham.,  chin.,  dulc.,^tpec.,  nux,  puls.,  sec.,  sil., 
sulph.,  tart.,  verat. 

of  what  has  been   eaten :    Ant.,  ars.,  bell.,  bry., 

calc.,  chin.,  colch.,  coloc.,  cupr.,  dros.,  fer.,  hyos.,  ign., 
ipec.,  lach.,  laur.,  lye.,  natr.-m.,  nux,  phos.,  plumb.,  puls., 
Sep.,  sil.,  stann.,  sulph.,  verat. 

of  Excrement:   Bell.,  bry.,  nux,  op.,  plumb. 

Frothy :  jEth.,  verat. 

Gelatinous:   Ipec. 

Green:    Aeon.,   ars.,    cann.,   ipec.,  lach.,   phos., 

plumb.,  puls.,  verat. 
—-  Milky:  ^Eth. 
^.         of  Milk  used:  jEth.,  samb. 

of    Mucus:    Aeon.,  aeth.,   ars.,   bell.,  bor.,  bry., 

cham.,  chin.,  cupr.,  dig.,  dros.,  dulc.,  hyos.,  ipec.,  lach., 
mere.,  nux,  phos.,  puls.,  sulph.,  verat. 

of  Bloody  Mucus:  Aeon.,  hep.,  hyos.,  lach.,  nitr. 

of  Green  Mucus;  Aeon.,  ars.,  ipec.,  lach.,  phos., 

puls.,  verat. 

Painful:  Asar.,  tart. 

Periodical:   Cupr.,  nux. 

Salt:  Magn.,  natr.-s. 

Vomiting  Sour:  Ars.,  bell.,   bor.,  calc.,  caus.,  cham., 


202  CHOLERA    REPERTORY. 

chin.,  fer.,  graph.,  hep.,  ipec.,  lye.,  nux,  phos.,  phos.-ac., 
puls.,  sass.,  stram.,  sulph.,  tab.,  tart.,  thuj.,  verat. 

Vomiting  Violent :  Ars.,  bell.,  cupr.,  iod.,  lach.,  nux, 
plumb.,  tart.,  verat. 

Watery :  Ars.,    bell.,  caus.,  chin.,  cupr.,  hyos., 

/nt.,  magn.,  sil.,  stann.,  stram.,  sulph. -ac.,  tab.,  verat. 

Yellowish:  Ars.,  iod.,  oleand.,  plumb. 

Yellow,  wilh  tinge  of  Green  :  Oleand.,  verat. 

CAUSES  OR  CONDITIONS  OF  THE  VOMITING. 

Vomiting  after  acids  :  Fer. 

after  Bread:   Nitr.-ac. 

from  the  motion  of  a  carriage:  Ars.,  cocc.,  nux, 

petr.,  sil.,  sulph. 

after  a  Chill :  Bell. 

Vomiting  after  Drinking;  Arn.,  ars., bry., nux,  puls.,  sil. 

relieved  by  Drinking:   Cupr. 

— —  bitter  after  Drinking:  Ars.,  nux.,  sil.,  verat. 
Vomiting  after  Eating:    Ars.,  calc.,  fer.,  iod.,  ipec., 
lach.,  nux,  phos.,  puls.,  sep.,  sil.,  stann.,  sulph.,  verat. 

Evening  (in  the):  Bell.,  bry.,  phos.,  puls.,  sulph. 

Morning  (in  the) :  Bar.-m.,  dig.,  dros.,  nux,  sil., 

sulph. 

Night  (at):  Ars.,  bry.,  caus.,  dig.,  dros.,  fer.,  lye., 

mere.,  mur.-ac.,  nux,  phos.,  puls.,  sulph.,  verat. 

in  Pregnancy:  Aeon.,  ars.,  con.,  fer., ipec.,  kreos., 

lach.,  magn.-m.,  natr.-m.,  n.-mos.,  nux,  petr.,  phos.,  puls., 
Sep.,  verat. 

Vomiting  after  Smoking  or  Stooping:  Ipec. 

from  the  motion  of  a  Ship:  Ars.,  cocc.,  nux,  petr., 

sil.,  sulph. 

after  Sucking  :  Sil. 


CONCOMITANTS    OP    THE    VOMITING.  203 

CONCOMITANTS  OF  THE  VOMITING. 

Vomiting  with  Anxiety:  Ant.,  ars.,  nux. 

offensive  Breath  :    Ipec. 

Choking:   Hyos. 

Colic:  Ars.,  bry.,  nux,  plumb.,  puls.,  stram.,  tart., 

verat. 

Convulsions:   Ant.,  cupr.,  hyos.,  mere. 

— Cries  :   Ars. 

fear  of  Death:   Ars. 

Diarrhoea :  JEih.,  ant.,  ars.,  bell.,  coloc.,  cupr., 

jat.,  ipec.,  lach.,  phos.,  rheum.,  stram.,  tart.,  verat. 

pains  in  the  Ears  :   Puls. 

Eructations  :   Caus.,  mur.-ac. 

— —  Eyes  convulsed:    Cic. 

Face,  pale:  Puls.,  tart. 

perspiration  on  th,e  Face:   Camph.,  sulph. 

Feet,  cold :  Kreos.,  phos. 

Feet,  numb:   Phos. 

Hands,  cold:   Kreos.,  phos.,  verat. 

Hands,  hot :   Verat. 

Hands,  numb :   Phos. 

Heat:  Ars.,  bell.,  ipec.,  verat. 

Hiccough:  Bry. 

Legs,  cramped:  Nux. 

desire  to  lie  down:    Verat. 

•  Nausea :   Nux,  sulph.,  verat. 

Pain  in  the  back:   Puls. 

Pain  in  the   stomach:    Ars.,   cupr.,  hyos.,   ipec., 

lach.,  op.,  phos.,  plumb.,  sulph.,  tart.,  verat. 

Perspiration:   Ipec.,  sulph. 

Perspiration,  cold;  Camph. 


204  CHOLERA  REPERTORY. 

Vomiting,  with  rumbling:   Puls. 

•  Shivering:  Bry.,  phos. ,puls.t  tart.,  sulpb. 

Shivering  in  the  evening:  Bry.,  phos.,  sulph. 

Shuddering :   Verat. 

Sight,  obscure  :   Lach. 

Sleepiness:   Tart. 

Taste,  bitter:  Puls. 

*    Thirst :  Ipec. 

Throat,  burning :  Arg.,  puls. 

Trembling  :  Nux,  tart. 

Vertigo  :  Hyos.,  natr.-s. 

Weakness:  Ars.,  hyos.,  ipec.,  phos.,  verat . 

SENSATIONS  (PAINS,  &c.,)  AT  THE  STOMACH  AND  PIT 
OF  THE  STOMACH. 

Burning  in  the  pit  of  the  stomach:  Aeon.,  ant.,  ars., 
bell.,  bry.,  laur.,  mere.,  nux,  phos.,  sec.,  sep.,  sil.,  sulph., 
verat. 

— —  In  the  stomach:  Ars.,  bell.,  bry.,  camph.,  canth., 
caps.,  carb.-v.,  cham.,  cic.,  graph.,  ign.,  laur.,  mere. 
merc.-c.,  nitr.,  nux,  phos.,  phos.-ac.,  salad.,  sec.,  sep., 
sulph.,  verat. 

Cold  sensation  in  the  Stomach  or  pit :  Ars.,  bell.,  ign., 
lach.,  laur.,  phos.,  phos.-ac.,  rhus,  sulph. 

Cramp  :  (See  spasmodic  pains.) 

Sensation  of  Emptiness  in  the  Stomach:  Ant.,  ign., 
petr.,  sep.,  tart.,  verat. 

Sensation  of  Fulness  in  the  Stomach  and  pit :  Arn., 
bar.-c.,  bell.,  carb.-v.,  cham.,  grat.,  hell.,  kal.,  lye.,  nux, 
petr.,  phos,,  sulph. 

after  a  meal:   Also,  chin.,  mere.,  puls.,  sep.,  sil. 

Pressure  in  the  pit  of  the  stomach:    Aeon.,  am.,  ars. 


STOMACH.  205 

bell.,  camph.,  cham.,  chin.,  coff.,  coloc  ,  cupr.,  hep.,  ign., 
mere.,  natr.-m.,  nitr.,  nux,  phos.,  phos.-ac.,  prun.,  puls., 
ran.,  ran.-sc.,  rhod.,  rhus,  scp.,  stann.,  sulph. ^tart.,  verat. 

Pressure  in  the  stomach :  Aeon.,  agar.,  anac.,  arn.,  ars., 
bar.-c.,  bell.,  bis.,  bry.,  calc.,  canth.,  carb.-an.,  carb.-v., 
cham.,  chin.,  etc.,  coff.,  coloc. ,  fer.,  graph. ,grat.,  hep.,  iod., 
ipec.,  lack.,  laur.,  led.,  lye.,  mere.,  mez.,  mosch.,  natr.,  natr.- 
m.,  nux,  par.,  petr.,  phos.,  plat.,  plumb.,  puls.,  rhod.,  rhus, 
sabin.,  sec.,  sen.,  sep.,  sil.,  spig.,  squill.,  stann.,  stram., 
sulph.,  tart. 

Pain  in  the  Pit  of  the  Stomach,  and  in  the  chest,  after 
a  meal :  Bry. 

Pain  in  the  Stomach  and  chest,  after  a  meal :  Chin., 
lach.,  phos. 

Shootings  in  the  pit  of  the  Stomach :  Arn.,  bell.,  bry., 
kal,  nit-ac.,  phos.,  puls.,  rhus.,  sep.,  sulph.,  tart. 

In  the  stomach  :  Bell.,  bry.,  coff,  ign.,  kal.,  plat., 

sep.,  sulph. 

Spasmodic  pains  in  the  stomach  :  Ant.,  ars.,  bell.,  bis., 
bry.,  cole.,  carb.-a  ,  carb.-v.,  caus.,  cham.,  chin.,  cocc.,  coff., 
con.,  cupr.,  fer.,  graph.,  hyos.,  kal.,  lach.,  lye.,  mere., 
natr.-m.,  nux,  phos.,  puls.,  sec.,  sep.,  sulph.,  verat. 

Swelling  of  the  pit  of  the  stomach:  Aeon.,  calc.,  hep., 
lye.,  sulph. 

Sensation  of  swelling  there :  Bry. 

Tenderness  of  the  stomach  and  region  of  the  stomach : 
Am.-c.,  am. -in.,  ant.,  ars.,  bar.-c.,  bry.,  calc.,  camph., 
canth.,  carb.-v..  caus.,  colch.,  coloc.,  hep.,  hyos.,  kreos., 
lach.,  lye.,  magn.-m.,  mere.,  natr.,  natr.-m.,  nux,  ol.-an., 
phos.,  phos.-ac.,  puls.,  rhus-rad.,  sil.,  spong.,  stann.,  sulph., 
sulph. -ac.,  tart.,  tereb.,  verat. 
10 


206  CHOLERA  REPERTORY. 

Tension  in  the  Pit  of  the  stomach:  Acon.,.ant.,  cham., 
nux. 

in  the  Stomach:  Aeon.,  bry.,carb.-v.,kal.,  mere., 

staph. 

Throlbings  in  the  region  of  the  stomach :  Aeon.,  bell., 
kal.,  puls.,  rhus.,  sep.,  sulph.,  tart.,  thuy. 

DIARRHCEA    IN    GENERAL. 

Aeon.,  alum.,  am.-m.,  ant.,  am.,  ars.,  bell.,  bor.,  bry., 
calc.,  carb.-v.,  cham.,  chin.,  cic.,  coff.,  coloc.,  con.,  cupr., 
dig.,  dros.,  dulc.,  fer.,  graph.,  hep.,  hyos.,  ign.,  ipec.,  lack., 
laur.,  lye.,  mere.,  natr.-m.,  nitr.-ac.,  nux.,  petr.,  phos., 
phos-ac.,  puls.,  rheum.,  rhus.,  sep.,  sil.,  strain. ,  sulph., 
sulph. -ac.,  verat. 

% 

COLOR    OF    THE    FAECES- 

Color,  Black  :  Ars.,  bry.,  calc.,  camph.,  chin.,  ipec., 
mere.,  nux.,  op.,  phos.,  str am.,  sulph.,  sulph.-ac., 
VBrat. 

Brownish  :  Ars.,  camph.,  dulc.,  magn.,  magn.-m., 

merc.-c.,  rheum.,  rhus-rad.,  sulph.,  verat. 

Clay-like:  Calc.,  hep. 

Greyish  :  Merc.,  phos.,  phos.-ac.,  rheum. 

Greenish  i  Ars.,  bell.,  cham.,  coloc.,  dulc.,  hep., 

ipec.,   magn.,   magn.-m.,  mere.,  merc.-c.,  nux., 
phos.,    phos.-ac.,    puls.,    rheum.,   sep.,    sulph., 
sulph.-ac.,  verat. 

Pale  :   Carb.-v.,  lye. 

Whitish:    Aeon.,  ars.,  calc.,  caust.,  cham.,  chin., 

colch.,  cop.,  dig.,  hep.,  ign.,    iod.,  nux.,  phos., 
phos.-ac.,  puh.,  rhus,  spig.,  spong.,  sulph. 


ODOR    OF    THE    FJ3CES.  207 

White,  like  milk  :    Am.,  bell.,  dulc.,  mere.,  nux, 

rheum. 

White,  like  flocks  :  Vide,  Cholera  Repertory. 
White,  in  streaks  :  Rhus-tox. 
Yellowish :  Ars.,  calc.,  cham.,  chin.,  coco-.,  coloc., 

ign.,  ipec.,  mere.,  phos  ,  plumb.,  puls.,  sulph., 

terb. 
Yellow,  in  streaks  :    Rhus-tox. 


ODOR    OF    THE    FAECES. 

Odor :  Corpse-like  :  Sil.,  Carb.-v. 

Foetid:    Ars.,  calc.,  cham.,  coloc.,  lach.,  mere., 

merc.-c.,  nitr.-ac.,  nux,  op.,  phos.-ac.,  plumb., 
rheum.,  sep.,  squill.,  sulph. -ac.,  tab. 

Putrid:    Ars.,  bry.,  carb.-v.,  cham.,  chin.,  coloc., 

graph.,  mere.,  nitr.-ac.,  nux,  sep.,  sulph.,  sulph.-ac. 

Sour:    Arn.,  calc.,  coloc.,  graph.,  magn.,  mere., 

rheum.,  sep.,  sulph. 

COMPOSITION    AND    CONSISTENCE    OF    THE    FAECES. 

Faeces :    acrid:    Ars.,  cham.,   fer.,  lach.,  mere  ,  puls. 
sass.,  verat. 

Bilious  :  Ars.,  dulc.,  ipec.,  mere.,  merc.-c.,  puls. 

—  Bloody:  Arn.,  ars.,  caps.,  carb.-v.,  colch.,  coloc., 

dulc.,  ipec.,  lacb.,  mere.-,  merc.-c.,  nitr.-ac..  nux. 

Coated  with  Blood  :  Con.,  magn.-m.,  nux,  squill., 

thuy. 

Burning  :  Ars.,  lach.,  mere. 

Clay-like :  Calc. 

Corrosive  :     See  Acrid. 

not  Digested:  Arn.,  ars.,  bry.,  calc.,  cham.,  chin., 


208  CHOLERA    REPERTORY. 


con.,  fer.,  lach.,  mere.,  nitr.-ac.,  oleand.,  phos., 

phos.-ac.,  squill.,  sulph. 
not  Digested  at  night,  or  after  meals  :   Chin. 
Fermented :    Ipec.,  sabad. 
Frothy :  Calc.,  coloc.,  iod.,  lach.,  mere.,  op.,  rhus., 

sulph  .-ac. 

Gelatinous :  Rhus.,  sep. 
Purulent:    Am.,  bell.,  calc.,  canth.,  chin.,  clem., 

cocc.,  con.,  ignat.,  iod.,  kal.,   lye.,  mere.,  nux, 

petr.,  puls.,  sabin.,  sec.,  sil.,  sulph. 
Slimy  :  Ang.,  arn.,  ars.,  bell.,  caps.,  carb.-v.  cham., 

chin.,  coloc.,  dulc.,  fer.,  graph.,  hell.,  iod.,  ipec., 

kal.,  mere.,  nitr.-ac.,  nux,  phos.,  phos.-ac.,  puls., 

rheum.,  rhus.,  sec.,  sep.,  squill.,   stann.,  sulph., 

tart.,  verat. 
Viscous ;    sticky :    Calc.,  carb.-v.,  caust.,   hep., 

lach.,  mere.,  nux.,  plumb.,  sass.,  verat. 
Watery:  Aeon.,  ant.,  arn.,  ars.,  bell.,  calc.,  cham., 

chin.,  for.,  hyos.,  jat.,  ipec.,  lach.,  nux.,   petr., 

phos.,  phos,-ac.,  puls.,  rhus.,  sec.,  sulph.,  tart., 

verat. 


CAUSES,  OR   CONDITIONS    OF   DIARRHOEA. 

Diarrhoea  :  from  Acid  things  :  Lach. 

after  taking  Cojd  :   Sell.,  bry.,  caust.,  cham.,  chin., 

dulc.,  mere.,  n.-mos.,  nux.,  puls  ,  sulph.,  verat. 

in  the  Coolness  of  the  evening  :  Merc. 

in  Damp  weather  :  Lach.,  rhod. 

Day  and  Night :   Sulph. 

after  Drinking:  Ars.,  cin. 

in  the  Evening  :  Caust.,  kal.,  lach.,  mere. 


CONCOMITANTS    OP    DIARRHO3A.  209 

Diarrhoea,  in  Feeble  persons :  Chin. ,  fer. ,  rhus,  phos.-ac.,  sec . 

after  Fruits  :  Chin.,  lach.,  rhod. 

from  Grief:  Ign. 

from  Indigestion:  Ant.,  coff..  ipec.,  puls.,  nux. 

after  a  Meal :  Ars.,  chin.,  lach.,  verat. 

after  Milk:   Dry.,  lye.,  sep.,  sulph. 

in  the  Morning  :  Bry. 

at  Night:  Ars.,  bry.,  cham.,  chin.,  dulc.,  lach., 

mere.,  mosch.,  puls.,  rhus.,  sulph.,  verat. 
of  Old  persons  :  Ant.,  bry.,  phos.,  sec. 

of  Pregnant   females:    Ant.,   dulc.,   hyos.,   lye., 

petr.,  phos.,  sep.,  sulph. 

of  Scrofulous  persons  :   Ars.,  bar.-c.,  cole.,  chin., 

dulc.,  lye.,  sep.,  sil.,  sulph. 

when  Sleeping :  Arn.,  puls.,  rhus. 

during  Warm  Weather  :  Lach. 

CONCOMITANTS    OF    D  I  A  R  R  H  OZ  A  . 

Diarrhoea  with:  Abdomen  distended:  Graph.,  sulph., 
verat. 

— Anguish :  Ant.,  lach.,  mere. 

excoriation  of  the  Anus  :  Cham.,  mere.,  sass. 

Colic,  cutting:  Aeon.,  agar.,  ang.,  ant.,  ars.,  asa., 

bar.-c.,  bry.,  cann.,  canth.,  cham.,  coloc.,  dulc., 
hep.,  ipec.,  lach.,  mere.,  merc.-c.,  mez.,  nux., petr., 
puls.,  rat.,  rheum.,  rhus.,  stront.,  sulph.,  verat. 

alternately  with  Constipation:    Bry.,  lach.,  nui., 

rhus. 

with   Cries    and   tears,   in   Children:     Carb.-v., 

cham.,  ipec.,  rheum.,  sulph. 

Debility  :  Ars.,  chin.,  ipec.,  phos-.,  sep  ,  verat. 


210 


CHOLERA    REPERTORY. 


Diarrhoea,  Eructations  :  Con.,  dulc.,  mere. 

Heat:  Merc. 

pain  in  the  Limbs :  Am.-m.,  rhus. 

pain  in  the  Loins  :  Nux. 

Nausea:  Ars.,  bell.,  ip.,  lach.,  mere. 

cold  Perspiration  on  the  face  :  Merc. 

Shiverings:   merc.,puh.,  sulph. 

pain  in  the  Stomach :    Bell.,  bry. 

Tenesmus :  Ars.,  ipec.,  lach.,  mere.,  nux.,  rheum., 

rhus.,  sulph. 

Thirst :  Ars  ,  dulc. 

Vomitings :   Ars.,  bell.,  coloc.,  cupr.,  dulc.,  ipec., 

lach.,  phos.,  rheum.,  stram.,  tart.,  verat. 

THE    MORE    USUAL    GROUPS    OF    DIARRHCEIC 
SYMPTOMS.* 

Acrid  and  brown  stools  :  Ars.,  verat. 

Black  and  green  stools :  Ars.,  ipec.,  mere.,  phos., 
sulph.-ac.,  verat. 

Blackish  stools  after  abuse  of  ipecac  :  Chin. 

Bloody,  mucous  and  foetid  stools :  Lach.,  merc.-c., 
sulph.,  sulph.-ac. 

Brown  and  green  stools  :  Ars.,  dulc.,  magn.,  magn.-m., 
merc.-c.,  sulph.,  verat. 


*  These,  being  nature's  groupings,  are  of  more  practical  value, 
than  those  which  are  formed  merely  from  the  Materia  Medica,  with- 
out reference  to  any  observation  of  their  actual  occurrence  in 
natural  disease.  The  author,  like  most  practitioners,  has  observed 
all  of  them  in  the  latter,  and  most  of  them  a  great  number  of  times. 
Those  who  practice  accurately,  often  study  to  find  the  remedies 
adapted  to  groups :  if  they  recorded  and  preserved  the  results  of 
their  calculations,  the  aggregate  of  those  collected  by  different 
physicians  would  form  a  valuable  repertory  for  general  practice. 


DIARRHCEIC    GROUPS.  211 

Brown  and  watery  stools  :  Ars.,  dulc.,  sulph.,  tart. 
Brown  stools,  with  nausea  from  movement :  Ars. 
Clay-colored   and   frothy   stools    in   diarrhoea :    Calc., 
rhus-rad. 

Diarrhoea  after  fruit ;   with  sighing  respiration  :    Lach. 

at  night,  with  distension  of  the  stomach  and  ab- 

domen after  meals:  Bor.,  bry.,  caust.,  cham., 
chin.,  dulc.,  kal.,  lach.,  mere.,  puls.,  rhus-tox., 
sulph. 

—  during  dentition  ;   white  coat  on  the  tongue  ;  yel- 
lowish stools  :   Calc.,  ipec.,  mere.,  sulph. 

painless   and   at  night:    Ars.,  bor.,  bry.,  canth., 

cham.,  chin.,  dulc.,  mere.,  puls.,  rhus-tox.,  sulph., 
verat. 

with  colic  and  at  night :    Ars.,  bor.,  bry.,  cham., 

dulc.,  lach.,  mere.,  puls.,  rhus-tox.,  sulph.,  verat. 

with  colic  and  tenderness  of  the  abdomen  :  Aeon., 

canth.,  cham,,  merc.-c.,  nux,  puls.,  rhus-rad., 
stram.,  sulph.,  terb.,  verat. 

with  colic  ;  stools  foetid  :  Ars.,  bry.,  coloc.,  ip*ec., 

lach.,  mere.,  nux,  stram.,  sulph. 

with  colic;  stools  green:  Ars.,  bor.,  coloc.,  phos., 

puls.,  verat. 

with  white  coat  on  the  tongue,  and  yellow  stools  ; 

Amb.,  calc.,  ign.,  ipec.,  mere.,  oleand.,  petr., 
phos.,  puls.,  sulph. 

with  involuntary  evacuations  at  night :   Ars.,  bry., 

chin.,  lach.,  mere.,  puls.,  rhus-tox.,  sulph.,  verat. 

with  sweat  on  the  face,  nausea  and   stiffness  of 

the  neck,  and  pain  in  it  when  moving  it :  Camph. 


212  CHOLERA  REPERTORY. 

Foetid  and  green  stools:    Ars.,  cbam.,    coloc.,   Inch., 

mere.,  merc.-c.,  nux,  sep.,  sulph.,  sulph.-ac.  tab. 
Foetid  stools,  in  diarrhoea  with  colic  :  Ars.,  bry.,  coloc., 

ipec.,  lach.,  mere.,  nux,  stram.,  sulph. 
Frothy  and   involuntary  stools,    in   diarrhoea  :    Chin.. 

mere.,  op.,  rhus-lox.,  su/ph. 
Green   and   slimy   stools  :    Ars.,    bell.,    bor.,   canth., 

chain.,    coloc.,    dulc.,  ipec.,   laur.,  mere.,    nux, 

phos.,  puls.,  sep.,  stan.,  sulph.,  sulph.-ac.,  tab. 
Green,  slimy  and  undigested  stools  :  Ars.,  bor.,  cham., 

nitr.-'dc.,phos.,  phos.-ac.,  rheum,  sulph.,  sulph-ac. 
Green,  sour  and  undigested  stools  :  Merc.,  sulph. 
Watery  stools,  in   diarrhoea   with  colic  :  Ars.,   cham., 

dulc.,  lach.,  nux,  puls.,  rhus-tox.,  sulph  , 
Watery  stools  with  brown  coat   on   the   tongue,  and 

vomiting  at  night :   Bell.,  phos.,  sulph. 

CHOLERA  INFANTUM,  DIARRHCEA  OR  CHOLERA 
MORBUS  OF  INFANTS,* 

Cholera  Infantum  in  general:  Aeon.,  ars.,  bell.,  bry., 
calct,  cham.,  dulc.,  hep.,  ipec.,  mere.,  nux,  puls.,  sep., 
sulph.,  verat. 

Cholera  Infantum,  with : 

Abdomen   distended :     Ars.,    bell.,  bry.,    cham., 

mere.,  nux,  puls.,  sep.,  sulph. 

— distended,   and  pained  during  the   evacuations : 

Ars.,  bry.,  cham.,  mere.,  nux,  sep.,  sulph. 
Cholera  Infantum,  with  Cerebral  disease  :  Bell. 


*  The  disease  called  Cholera  Infantum,  by  American  physicians, 
prevails  during  the  hot  season  in  the  Middle  States,  and  is  often  fata 
in  citiea. 


DYSENTERY.  213 


Cholera  Infantum,  with  Fever,  thirst,  hot  and  dry  skin, 
pulse  hard,  and  frequent :  Aeon.* 

with    Stools    green  :     Ars.,    bell.,    cham.,  dulc., 

ipec.,  mere.,  nux,  puls.,  sep.,  sulph.,  verat. 

with  Stools  yellow  and  slimy:  Ars.,  cham.,  ipec., 

mere.,  puls.,  sulph. 

with  Vomiting  diarrhoea  and  Slimy  Stools  :  Ars., 

bell.,  ipec.,  rheum,  verat. 

It  is  unnecessary  to  dwell  longer  on  Cholera  Infantum 
in  particular,  inasmuch  as  the  other  parts  of  this  Reper- 
tory afford  a  sufficient  guide  for  the  treatment  of  this  dis- 
ease ;  especially  if  the  remedies  for  each  symptom  of  the 
case  be  compared  with  the  list  given  (at  the  head  of  this 
section,)  as  the  remedies  for  Cholera  Infantum  in  general. 
It  is  not,  however,  necessary  to  be  confined  to  them,  if  the 
whole  group  of  symptoms  indicates  some  other  remedy. 
Symptomatology,  here  as  elsewhere,  is  the  grand  basis  of 
treatment. 

DYSENTERY. 

Dysentery  in  general:  Aeon.,  ars.,  bell.,  bry.,  canth., 
caps.,  carb.-v.,  cham.,  chin.,  colch.,  coloc.,  dulc.,  ipec., 
mere,  merc.-c.,  nitr.-ac.,  nux,  phos.,  puls.,  rhus,  sulph., 
verat. 

Dysentery  with  dryness  of  the  Lips  :  ^c«n.,bell.,  bry., 
chin.,  lach.,  mere.,  nux,  rhus,  sulph. 

with  tenderness  of  Stomach  and  Abdomen:  Nux, 

puls.,    sulph. 


*  At  the  commencement  of  the  treatment,  Aconite  is  generally 
advisable. 


214  CHOLERA  REPERTORY. 

Dysentery,  with  tenderness  of  Abdomen :  Aeon.,  bell.,  cham., 
mere.,  nux,  puts.,  sulph. 

with  Stools  of  Bloody  mucus,  sometimes  Green  : 

Merc.,  merr.-c.,  nux,  puls.,  sulph. 

with  Burning  in  the  Abdomen  and  Soles  :    Merc. 

with  Bloody  mucous  Stools  and  Tenesraus  :  Lach. 

mere.,  merc.-c.,  nux,  rhus.,  sulph. 

For  other  symptoms  and  groups  in  any  particular  case 
of  dysentery,  see  other  sections  of  this  Repertory,  and 
compare  the  medicines,  under  each  symptom  of  the  case, 
with  those  for  dysentery  in  general. 


APPENDIX  I. 

AN    ESSAY    ON    EPIDEMIC    CHOLERA, 

BY  B.    F.    JOSLIN,    JR.,    M.D. 

PRESENTED     TO     THE      UNIVERSITY     OF     THE     CITY     OF    NEW-YORK,    FOR     THE 
DEGREE    OF    DOCTOR    OF   MEDICINE.— SESSION    1851-2." 

THE  early  history  of  the  Cholera  is  involved  in 
some  obscurity ;  for  while  some  contend  that  it 
has  existed  in  this  country  and  in  Europe  only 
during  a  comparatively  recent  period,  others  believe 
firmly,  that  the  epidemics  with  which  we  have  been 
visited  were  only  a  more  general  prevalence  of  the 
Cholera  Morbus,  which  is  always  more  or  less  preva- 
lent during  the  warmer  months.  In  the  descrip- 
tions of  Cholera  Morbus  contained  in  the  older  books, 
the  evacuations  both  from  the  stomach  and  bowels, 
are  described  as  consisting  "  chiefly  of  bile."  Any 
person  who  has  seen  the  epidemic  cholera,  knows 
that  in  it  the  evacuations  '  are  characterized  by  an 
entire  absence  of  this  fluid ;  that  though  in  rare 
cases,  the  dejections  may  be  slightly  tinged  with 
bile,  still  in  no  case  which  they  would  consider  as 
epidemic  Cholera,  are  the  matters  ejected  from  the 


216  APPENDIX. 


body  decidedly  bilious.     A  comparison  of  the  symp- 
toms enumerated  as  belonging  to  Cholera  morbus, 
and  those  of  epidemic  or  malignant  Cholera,  will  I 
think,  be  sufficient  to  convince  any  one,  that  those 
diseases,  though  resembling  each  other  in  some  par- 
ticulars, are  nevertheless  not  identical.     The  testi- 
mony of  medical  men  \vho  had  had  long  experience, 
and  who   witnessed   the  first  epidemic  of  Cholera, 
proves  that  the  disease  was  one  which  they  had  not 
previously   been   accustomed    to    meet   in    practice. 
Watson   says,    (Prac.   of  Med.   p.   407,)   "the   late 
Dr.  Babington  told  me  that   it  was  quite  new  to 
him.     He  had  for  a  very  long  period  been  in  exten- 
sive practice  in  those  parts  of  the  metropolis  and  its 
vicinity  where   the  epidemic    Cholera  jaged   most : 
and  when  it  first  came  among  us,  he  had  the  curiosity 
to  ask  every  medical  man  whom  he  met,  whether  he 
had  seen  any  case  of  the  Cholera,  and  if  the  answer 
was  "  Yes,"  he  went  on  to  inquire,  whether  before 
that  year  the  person  had  ever  met  with  the  same 
complaint :    and   the  reply  was  always,  without  a 
single  exception  "No."    Dr.  Ackerly,  who  was  physi- 
cian to  one  of  the  Cholera  hospitals  in  New- York, 
during  the  epidemic  of  1832,  says  in  his  report,  that 
"nothing  like  the  late  epidemic  and  malignant  Chole- 
ra has  occurred  to  my  notice  in  twenty-four  years 
practice." 

Among  those  who  believe  epidemic  cholera  to  be  a 
disease  essentially  different  from  Cholera  morbus,  it 
has  been  a  question  whether  it  first  originated  in 


AN  ESSAY  ON  EPIDEMIC    CHOLERA.  217 

India  in  1817,  or  had  been  endemic  there  for  a  much 
longer  period.  That  the  disease  which  we  know  by  the 
several  designations  of  Epidemic,  Malignant,  or 
Asiatic  Cholera,  was  known  in  India  previous  to  the 
commencement  there  of  the  epidemic  which  traversed 
a  great  portion  of  the  globe  from  1817  to  1833  or  34, 
is  probable  from  the  evidence  of  resident  -surgeons 
and  early  writers. 

As  early  as  1629,  BONTIUS,  a  Dutch  physician, 
wrote  at  Batavia,  an  account  of  what  he  calls 
"  Cholera  Morbus ;"  but  from  his  description  it 
appears  to  have  more  nearly  resembled  epidemic 
cholera.  He  says  "this  disease  is  attended  with  a 
weak  pulse,  difficult  respiration,  and  coldness  of  the 
extreme  paj-ts  ;  to  which  are  joined  great  internal 
heat,  insatiable  thirst,  perpetual  watching,  and  rest- 
less and  incessant  tossing  of  the  body.  If  together 
with  these  symptoms,  a  cold  and  foetid  sweat  should 
break  forth,  it  is  certain  that  death  is  at  hand."  In 
his  description  of  Cholera  Morbus  he  says  nothing  of 
the  spasms  of  the  extremities,  but  he  speaks  of  a 
person  who  died  of  this  disease,  as  having  died  in 
convulsions.  He  also  witnessed  a  disease  that  he 
calls  "  Spasm,"  which  there  is  reason  to  think  was 
nothing  but  the  spasmodic  variety  of  Cholera. 

Dr.  PAISLEY,  writing  at  Madras,  in  1774,  speaks 
of  "  Cholera  Morbus"  as  being  "  often  epidemic," 
and  accompanied  with  "sudden  prostration  of 
strength,  and  spasms  over  the  whole  surface  of 
the  body"  He  attributes  the  disease  to  the  ef- 


218  APPENDIX. 


fects  of  "highly  putrid  bile;"  but  his  description 
contains  no  information  in  regard  to  the  appearance 
of  the  evacuations  :  his  opinion  as  to  the  cause  of  the 
disease  appears  to  be  merely  hypothetical.  SON- 
NERAT,  who  travelled  in  India,  between  the  years 
1774  and  1781,  speaks  of  several  epidemics  of  dis- 
ease, the  symptoms  of  which,  as  he  relates  them, 
very  nearly  resemble  the  Cholera  as  it  has  appeared 
in  this  country.  He  says,  "  the  symptoms  of  this 
disorder  were  a  watery  flux,  accompanied  with  vomit- 
ing and  extreme  faintness,  a  burning  thirst,  an  op- 
pression of  the  breast,  and  suppression  of  urine. 
Sometimes  the  diseased  felt  violent  colicky  pains  ; 
often  lost  his  speech  and  recollection,  or  became  deaf; 
the  pulse  was  small"  Another  epidemic,  occurring 
two  years  _after,  "first  showed  itself  By  a  watery 
flux,  which  came  in  an  instant ;  and  sometimes  cut 
the  diseased  off  in  less  than  four  and  twenty  hours. 
Those  who  were  attacked  had  thirty  evacuations  in 
five  or  six  hours  ;  which  reduced  them  to  such  a  state 
of  weakness  that  they  could  neither  speak  nor  move. 
They  were  often  without  pulse  ;  the  hands  and  ears 
were  cold;  the  face  lengthened  ;  the  sinking"  of  the 
cavity  of  the  socket  of  the  eye  was  the  sign  of 
death;  they  felt  neither  pains  in  the  stomach, 
colics,  nor  gripings.  The  greatest  pain  was  a 
burning  thirst"  An  English  surgeon,  Mr.  CURTIS, 
in  India,  in  1782,  described  a  disease  which  occurred 
in  the  national  vessel  to  which  he  was  attached. 
He  enurnera'tesfflnost  of  the  more  striking  phenomena; 


AN  ESSAY  ON  EPIDEMIC  CHOLERA.  219 

of  the  cholera  as  being  present  in  the  disease  he 
witnessed  ;  as,  general  tonic  spasms,  the  evacuations 
consisting  of  "  nothing  but  a  thin  watery  matter,  or 
mucus  ;"  coldness  of  the  extremities,  and  subse- 
quently of  the  whole  body  ;  the  pulse  "  sometimes 
sunk  so  much -as  not  to  be  felt  at  the  wrist,  in  two 
or  three  hours  after  the  spasms  came  on  /"  "  in 
many,  the  stomach  became  so  irritable  that  nothing 
could  be  got  to  rest  upon  it ;  but  every  thing  that 
was  drank  was  spouted  out  immediately  ;  without 
straining  or  retching. 

His  account  of  the  appearance  of  the  hands  in  ex- 
treme collapse  is  characteristic.  "  The  hands  now 
begin  to  put  on  a  striking  and  peculiar  appearance. 
The  nails  of  the  fingers  became  -  livid,  and  bent 
inwards ;  the  skin  of  the  palms  became  white, 
bleached,  and  wrinkled  up  into  folds,  as  if  long 
soaked  in  cold  water ;  the  effect,  no  doubt,  of  the 
profuse  cold  sweat,  which  is  one  of  the  most  per- 
nicious and  fatal  symptoms  of  the  disease." 

He  also  speaks  of  patients  retaining  possession  of 
their  faculties  "to  the  last  moment  of  their  life,  even 
when  the  whole  body  had  become  perfectly  cold,  and 
all  pulsation  of  the  heart  had  ceased  for  a  long  time 
to  be  distinguishable."  This  disease  can  be  shown 
to  have  been  present  in  some  part  of  India,  during 
the  period  which  elapsed  between  the  last  mentioned 
date  and  the  year  1817,  when  it  seems  to  have  at- 
tracted more  general  attention  than  it  had  done  at 
any  previous  time.  From  the  above  extracts  we  may 


220  APPENDIX. 


conclude,  that  a  disease  similar  to  that  which  has 
visited  us  during  the  past  twenty  years,  has  heen 
prevalent  in  various  parts  of  India  as  an  epidemic,  at 
intervals  during  two  centuries ;  and  it  is  not  unlikely 
for  a  longer  period,  though  anterior  to  this  we  have 
no  records. 

In  August,  1817,  the  Cholera  appeared  almost  si- 
multaneously in  Calcutta  and  Jessore,  in  Hindostan, 
places  about  sixty  miles  apart.  It  is  somewhat  difficult 
to  determine  the  exact  point  at  which  this  epidemic  took 
its  start ;  but  it  is  certain  that  within  three  months  after 
its  appearance  in  the  above  places,  scarcely  a  spot 
existed  within  several  thousand  miles,  in  which  it 
had  not  committed  its  ravages.  In  some  localities 
the  mass  of  the  population  was  said  to  have  been  sen- 
sibly diminished.  It  is  not  my  design  to  detail  the 
routes  pursued  by  this  fearful  scourge ;  suffice  it  to 
say,  that  its  general  course  was  westerly,  though 
marked  by  many  deviations. 

Whether  Cholera  is  or  is  not  contagious,  it  very 
certainly  has  some  other  means  than  contagion  of 
propagating  itself;  and  its  history  has  shown  that 
neither  non-intercourse  nor  rigid  quarantine  regula- 
tions were  sufficient  to  stop  its  progress.  I  do  not 
intend  to  enter  fully  into  the  discussion  of  the  con- 
tagiousness of  this  disease,  but  will  however  relate 
the  particulars  of  one  instance,  which  illustrates  my 
own  view  of  this  subject.  On  the  second  of  Decem- 
ber, 1848,  the  ship  New-York,  arrived  at  the  quaran- 
tine, Staten  Island.  According  to  the  report  of 


AN  ESSAY  OF  EPIDEMIC  CHOLERA.  221 

Dr.  WHITING,  health  officer,  this  vessel  had  started 
from  Havre  with  345  passengers.  About  a  week  previ- 
ously to  arrival  here,  when  off  the  coast  of  Nova 
Scotia,  a  number  of  cases  of  disease  resembling 
Asiatic  Cholera  occurred,  which  terminated  very  sud- 
denly. Out  of  seventeen  cases,  seven  died.  Subse- 
quently to  these  persons  having  been  taken  to  the 
hospital,  there  occurred  in  the  latter  place  seventy- 
nine  cases,  out  of  whom  forty-five  died,  making  in 
all  ninety-six  cases  and  fifty-two  deaths.  Several  of 
these  cases  were  persons  not  having  been  passengers 
of  the  New-York.  Among  the  latter  was  one  of  the 
nurses  of  the  Institution.  This  is  perhaps  as  fair  an 
instance  as  could  have  been  selected  for  an  illustra- 
tion of  the  peculiar  habitudes  of  this  disease.  Here 
were  a  number  of  persons  completely  isolated,  as  a 
body,  from  the  influence  of  contagion,  and  at  a  distance 
from  any  point  at  which  the  Cholera  was  then  pre- 
vailing :  it  would  be  difficult  to  suppose  any  but]  an 
atmospheric  origin  in  this  instance.  But  further ; 
the  ship  arriving  at  quarantine,  where  no  cases  of 
this  disease  had  previously  occurred,  the  disease  still 
continues,  and  even  attacks  some  who  had  never 
been  in  the  infected  ship:  From  whence  did  these 
last  receive  the  infection  ?  This  last  circumstance 
•would  seem  to  indicate  that  the  Cholera  was  conta- 
gious, in  a  slight  degree.  From  the  above  facts  I 
deduce  the  following  conclusions  :  1st,  that  Cholera 
is  propagated  by  means  other  than  contagion ;  2d, 
that  under  circumstances  favorable  for  its  develop- 


222  APPENDIX. 

ment,  the  presence  of  cases  in  the  immediate  neigh 
borhood  acts  as  an  exciting  cause.  It  is  also  worthy 
of  being  noted  in  this  connection,  that  at  least  three 
persons  died  of  Cholera  in  the  City  between  the  sixth 
and  the  twentieth  of  the  same  month,  the  first  of 
whom  had  previously  been  discharged  as  cured  from 
the  quarantine  hospital. 

We  may  assume  that  Cholera  is  produced  by  a 
definite  poison,  without  aknowledging  the  truth  of 
any  of  the  various  hypotheses  which  have  been 
brought  forward  respecting  its  absolute  nature. 
This  poison  we  know  only  by  its  effects  ;  what  it  is, 
whether  ponderable  or  imponderable,  we  know  not : 
our  only  knowledge  is  derived  from  the  effects  which 
it  produces  upon  the  human  system.  Whether  we 
suppose  it  to  be,  like  variola,  generated  in  the  course 
of  the  disease  and  propagated  by  contagion,  or  pro- 
duced by  a  generally  diffused  miasm,  we  may^still 
consider  it  to  be  the  effect  of  a  specific  poison. 
Acting  under  more  or  less  favorable  circumstances, 
we  see  this  poison  producing  proportionate  results  : 
for  though  we  might  suppose  the  existence  of  this 
poison  at  all  times,  still  without  the  cooperation  of 
certain  predisposing  causes,  its  effect  would  not  be 
general.  That  much  of  this  specific  poison  does  at 
all  times  exist  in  those  localities  which  have  been 
visited  of  late  years  by  the  disease,  to  me  appears 
improbable ;  for  as  we  have  seen  that  there  is  no 
proof  of  its  having  often  shown  itself  by  the  produc- 
tion of  its  effect,  it  must  have  remained  latent  under 


AN  ESSAY  ON  EPIDEMIC  CHOLERA.  223 

a  multitude  of  circumstances  which  during  the  pre- 
sence of  an  epidemic  of  Cholera  seem  to  act  strongly 
as  predisposing  causes.  This  remark  is  applicable 
to  the  periods  intervening  between  the  occurrence 
of  the  several  epidemics,  as  well  as  to  times  previous 
to  the  first  and  subsequent  to  the  last. 

The  predisposing  causes  may  be  comprised  under 
the  meteorological  influences,  the  influence  of  locality, 
of  age,  of  individual  habits,  and  manner  of-  living. 

Meteorological  variations  have  in  numerous  in- 
stances preceded  the  appearance  of  Cholera.  Those 
conditions  of  the  atmosphere  which  have  appeared 
most'to  favor  its  development  are,  unusual  conditions 
of  heat  and  moisture,  and  alterations  in  its  electrical 
condition.  Thus  its  appearance  would  be  preceded 
by  long-continued  storms  of  rain  and  wind,  or  by 
thunder  storms.  In  other  instances  it  has  been 
known  to  succeed  a  long  continuance  of  dry  hot 
weather,  especially  if  this  state  be  succeeded  by  a 
sudden  fall  of  rain. 

The  localities  which  have  been  most  severely 
visited,  have  been  low  damp  situations.  Places  sit- 
uated near  marches  and  upon  the  borders  of  rivers 
have  been  especially  distinguished  during  the  course 
of  an  epidemic. 

Persons  at  about  the  middle  period  of  life  are  more 
liable  to  an  attack  of  this  disease  than  either 
children  or  the  aged.  Young  children  are  not  un- 
frequently,  during  an  epidemic,  attacked  with  symp- 
toms of  the  first  and  second  stages  of  Cholera;  but 


224  APPENDIX. 


in  them  it  rarely  terminates  in  collapse  ;  it  is  more 
common  in  these  cases  for  the  disease  to  run  into  a 
chronic  diarrhoea  accompanied  with  vomiting,  into,  in 
fact,  Cholera  infantum. 

The  following  are  tables,  compiled  from  reports  of 
the  physicians  having  charge  of  Cholera  hospitals, 
during  the  epidemics  of  1832  and  1849.  I  have  been 
unable  to  comprise  all  the  reports  of  either  epidemic  ; 
as  only  -those  arranged  according  to  a  uniform  plan 
would  answer  my  purpose. 

Of  590  patients  admitted  into  the  Park  hospital, 

during  the  epidemic  of  1832,  there  were 

11  patients  between  the  ages  of  1  and  10  years, 

49        "          «          "  "    "  10  "    20     " 

178*      "          "          "  "    "  20  "    30    " 

174        "          "          "  "    "  30  "    40    " 

91        «          «          "  "    "  40  «    50    " 

53        "          "          "  "    "  50  "    60    " 

28        "          "          "  "    "  GO  "    70    " 

6        "          "          "  "    "  70  "    90    " 

Of  407  patients  admitted  into  the  Eivington-street 
hospital, 

5  were  between  the  ages  of  1  month  and  1  year, 
42     "          "          "       u     "    1  year  and  10  years, 

4^        «  «  «  CC        «   J0        ..        ..        20        " 

116  "  "  "  "  "  20  "  "  30  " 

102  "  '*  "  "  "  30  "  "  40  " 

66  "  "  "  "  "  40  "  "  50  " 

21  "  "  "  "  "  50  "  "  60  " 


AN  ESSAY  OF  EPIDEMIC  CHOLERA.  225 


Of  281  patients  in  Corlear's  Hook  hospital,  there 
were  25  under  14  years  of  age, 

9  between  14    and    20  years, 
84        "        20      "      30      " 
88        "        30      '•      40      " 
47        "        40      "      50      " 
12        «        50      «      60      " 
14        «•       60      "      70      " 

2  who  were  over  70  years  of  age. 

From  the  above  it  will  be  perceived,  that  there  is 
very  little  difference  between  the  liability  of  persons 
to  an  attack  of  Cholera  between  20  and  30  years 
and  of  those  between  30  and  40  years.  The  fore- 
going are  from  the  reports  of  the  epidemic  of  1832, 
It  is  interesting  to  observe  how  nearly  the  following, 
taken  from  the  reports  of  1849,  resemble  them. 

Centre-street  hospital  received  483  cases  : 

53     under     20  years  of  age, 
279  between  20  and  40  years  of  age, 
141         "        40     "     60     "       "       " 

10  " '      60     "     70    "      "      " 

Thirteenth-street  hospital  received  275  patients,  of 
whom     63  were  under  20  years  of  age, 
157  between  20  and  40  years, 
48         "        40     "     60     " 
7         "         60     "     80     " 


226  APPENDIX. 

The  remarkable  similarity  in  regard  to  the  rela- 
tive proportion  of  those  attacked  at  certain  ages  in 
1832  and  1849,  is  shown  in  the  following  synopsis  of 
the  preceding  tables. 

In  1832,  14  per  cent,  of  those  attacked  were  under 
20  years  of  age, 

58  per  cent,  were  between  20  and  40  years, 
22        "          "        "        40    "   60    " 
4        "        were  over  60  years  of  age. 

In  1849,   15  percent,  were  under  20  years, 

60        "   .     between     20  and  40  years, 
21        "  "          40    "    60     " 

2        "        were  over  60  years. 

Thus  it  will  be  perceived,  that  the  greatest  number 
attacked  were  of  persons  between  the  ages  of  20  and 
40  years.  "In  proportion  to  the  number  of  persons 
living  at  a  certain  age,  probably  a  less  number  are 
attacked  of  those  under  20  years,  than  during  any 
other  period  of  the  same  length.  It  would  appear 
as  if  the  aged  were  in  some  degree  exempt  from  its 
influence ;  but  if  we  take  into  consideration  the  small 
proportion  of  persons  in  a  city  over  60  years  of  age, 
it  will  be  seen  that  their  liability  to  Cholera  is  quite 
as  great  as  that  of  those  under  20.  To  illustrate 
the  comparative  mortality  of  certain  ages  I  have  pre- 
pared the  following  tables  by  combining  the  hospital 
reports  of  1832  and  1849. 


AN  ESSAY  OF  EPIDEMIC    CHOLERA. 


227 


Under  10  years 58      31      27    46 

Between  10  and  20  years  .      122      79      43    35 
20     "  40      "  788    367    421    53 

40    "   60      "  194     72    122    63 

Over  60  years 27     11      16    69 

The  mortality  increases  from  youth  to  old  age,  as 
shown  by  the  per-centage  in  this  tahle. 

The  consideration  of  the  influence  of  the  habits 
and  manner  of  living  which  predispose  to  this  com- 
plaint, is  important  as  guiding  us  to  a  knowledge  of 
the  true  means  of  prevention.  Not  being  wholly 
arrested  in  its  progress  by  non-intercourse  with  af- 
fected localities,  nor  often  held  in  check  by  quaran- 
tine regulations,  it  is  evident  that  the  security,  either 
of  individuals,  or  of  masses  of  men,  is  only  to  be  at- 
tained by  removing  from  themselves,  as  far  as  possi- 
ble, every  cause  which  may  be  liable  to  act  as  a  pre- 
disponent.  Any  thing  which  tends  to  diminish  the 
general  tone  of  the  system,  acts  as  a  predisposing 
cause ;  irregularity  of  living,  or  dissipation  of  any 
kind,  long  watching  with  the  sick,  exposure  to  night 
air,  and  anxiety  of  mind,  are  all  unfavorable.  Of  all 
occupations,  that  of  a  physician  during  the  preva- 
lence of  an  epidemic  of  Cholera,  pre-eminently  dis- 
poses to  an  attack  ;  liable  to  be  called  upon  at  all 
hours  of  the  day  to  visit  the  sick,  not  unfrequently 


228  APPENDIX. 


in  crowded  and  ill-ventilated  apartments,  compelled 
to  undergo  fatigue  and  loss  of  sleep,  and  to  take  his 
meals  at  irregular  hours,  it  is  not  surprising  that 
many  of  this  profession  are  numbered  among  its  vic- 
tims. Nurses  and  those  who  attend  upon  the  sick 
are  of  course  exposed  in  some  degree,  not  so  much  in 
consequence  of  the  infectious  character  of  the  disease, 
as  owing  to  the  fact  that  such  persons  are  liable  to 
be  deprived  of  proper  rest  and  pure  air.  When 
several  persons  occupy  one  room  not  very  well  venti- 
lated, as  is  too  frequently  the  case  in  large  cities, 
they  are  very  much  exposed  during  an  epidemic,  par- 
ticularly if  the  situation  be  low  and  damp.  I  have 
remarked  that  the  dissipated  were  frequent  subjects. 
This  is  the  case ;  but  of  all  vices  none  predisposes  in 
so  great  a  degree  as  intemperance :  this  has  been 
remarked  by  almost  every  writer  upon  Cholera.  Of 
1615  cases  received  into  Cholera  hospitals  in  the 
epidemic  of  1832,  1023  were  decidedly  intemperate, 
a  proportion  of  nearly  two-thirds  :  of  the  remainder, 
482  were  intemperate  :  and  of  110  cases,  it  was  not 
known  whether  they  were  intemperate  or  not ;  it  is 
probable  that  a  proportion  were.  Both  in  the  epi- 
demic of  1832  and  in  that  of  1849,  the  Cholera  in 
New- York  first  appeared  and  was  more  fatal  in  the 
locality  known  as  the  "  Five  Points ;"  a  fact  which 
illustjates  what  has  been  previously  said  of  its  pre- 
disposing causes ;  this  place  possessing  in  itself  all 
the  elements  best  fitted  for  its  reception,  being  low 
and  damp,  and  the  inhabitants  filthy  in  the  last  de- 


AN    ESSAY    ON    EPIDEMIC    CHOLERA.  229 


gree.  Among  the  occasional  causes,  we  may  enume- 
rate the  eating  of  indigestible  food,  exposure  to  great 
fatigue,  and  a  depressed  state  of  the  mind. 

For  the  purpose  of  description,  we  may  divide 
Cholera  into  three  stages  or  periods.  The  first  stage 
I  shall  call  choleroid,  it  may  be  also  called  the  inci- 
pient stage.  The  second  is  the  period  of  full  devel- 
opment, and  the  third  the  stage  of  collapse  ;  should 
the  patient  survive  this  stage,  we  will  have  the  period 
of  reaction.  Either  of  these  stages,  choleroid,  full 
development,  or  collapse,  may  occur  without  being 
preceded  or  succeeded  by  either  of  the  others.  This 
remark  is  more  strictly  true  as  applied  to  the  first 
two  periods  ;  though  numerous  cases  of  collapse  have 
occurred,  without  having  been  preceded  by  any  pre- 
cursory symptoms  sufficient  to  excite  apprehension 
either  in  physician  or  patient.  The  term  cholerine 
is  usually  applied  to  the  diarrhoea  which  prevails 
during  the  presence  of  an  epidemic  of  Cholera,  and 
which  is  properly  the  first  stage  of  the  disease.  I 
have  employed  the  term  choleroid  as  designating  the 
first  stage,  for  the  purpose  of  including  a  class  of  ca- 
'ses  in  which  no  diarrhoea  exists.  I  shall  define  cho- 
leroid to  be  the  occurrence  of  one  or  more  of  any  of 
the  symptoms  of  Cholera  in  an  individual,  only  not 
sufficiently  numerous  or  severe  to  justify  us  in  con- 
sidering it  as  a  case  of  fully  developed  Cholera.  The 
diarrhoea  which  prevails  during  an  epidemic  of  this 
disease,  does  not  differ  in  its  character  from  the  di- 
arrhea which  prevails  at  other  times  when  no  Cholera 
11 


230  APPENDIX. 

exists.  The  evacuations  may  consist  of  ordinary 
faecal  matter,  or  they  may  be  large  and  watery  ;  they 
are  scarcely  attended  with  pain  or  uncomfortable  sen- 
sation to  the  patient :  this  I  consider  to  be  the  most 
distinctive  character  of  the  diarrhoea  preceding  Cho- 
lera. During  the  epidemic  of  1849,  instances  occur- 
red, in  which  persons  would  be  affected  with  some 
very  curious  symptoms,  apparently  in  consequence  of 
the  presence  of  the  Cholera  poison.  These  persons 
were  affected  by  some  among  the  more  peculiar  symp- 
toms of  Cholera.  These  cases  are,  I  am  satisfied,  to 
be  ranked  with  the  diarrhoea,  which  we  have  been 
considering  as  effects  of  the  Cholera  poison,  so  modi- 
fied by  circumstances  at  not  to  produce  its  full  effect. 
It  was  not  unusual  for  persons  to  be  troubled  with 
slight  spasms  of  the  gastrocnemii,  or  of  other  volun- 
tary muscles ;  these  taking  place  in  persons  who 
were  not  ordinarily  subject  to  them.  But  the  more 
interesting  cases,  were  those  in  which  I  observed 
symptoms  of  a  more  advanced  period  of  the  disease  : 
thus  a  large  number  of  persons  had  cold  tongues,  im- 
parting a  sensation  to  the  touch  like  that  of  a  frog's 
belly :  and  in  one  instance  I  observed  the  tongue  to 
be  not  only  cold,  but  of  a  bluish-black  color,  appear- 
ing as  if  it  had  been  covered  with  ink.  In  my  own 
person,  I  experienced  some  symptoms  of  a  similar 
character  to  the  above,  which  occurred  several  times 
during  the  continuance  of  the  epidemic  in  New- York  ; 
and  it  may  be  as  well  to  state,  that  I  have  never  ex- 
perienced them  at  any  other  time.  The  symptom 


AN    ESSAY    ON    EPIDEMIC    CHOLERA.  231 

most  marked  in  my  own  case,  was  a  blue  color  of  the 
last  phalynx  of  the  fingers.  The  blue  color  was  very 
decided,  not  unlike  that  of  indigo.  It  was  accompa- 
nied by  some  degree  of  corrugation,  the  appearance 
•  being  precisely  similar  to  that  observed  in  collapse; 
it  was  generally  attended  with  vertigo,  which  is  not 
an  unfrequent  symptom  in  Cholera.  These  symp- 
toms would  last  some  minutes.  I  observed  similar 
phenomena  in  other  persons,  only  in  less  degree.  The 
duration  of  the  choleric  stage  may  be  only  a  few 
hours,  or  it  may  be  several  days.  It  is  in  this  stage, 
that  the  disease  has  by  all  physicians  been  found 
most  amenable  to  treatment,  but  owing  to  the  salu- 
tary effect  attributed  to  evacuations  ;  under  all  pos- 
sible circumstances,  by  the  ignorant,  this  period  ia 
frequently  altogether  neglected,  and  the  disease  al- 
lowed to  become  fully  developed  before  active  means 
for  relief  are  resorted  to. 

In  the  fully  developed  stage,  the  evacuations  be- 
come large  and  colorless,  or  whitish  and  contain  albu- 
minous particles  ;  they  resemble  water  in  which  rice 
has  been  boiled,  with  particles  of  rice  floating  or  set- 
tling in  it.  The  patient  ejects  matters  from  the 
stomach  of  a  similar  character  to  those  dejected.  The 
matters  vomited  are  ejected  suddenly,  generally  with- 
out retching  or  nausea,  and  are  frequently  expelled 
with  such  force  as  to  carry  them  to  the  distance  of 
several  yards.  The  evacuations  frequently  amount  in 
quantity  to  several  gallons,  though  the  quantity  does 
not  have  any  relation  to  the  severity  of  the  attack. 


232  APPENDIX. 


I  remember  one  case,  which  I  saw  in  1849,  in  which 
the  patient  was  in  collapse  in  three  hours  after  the 
first  symptoms  were  observed,  and  in  which  the  pa- 
tient died  in  about  seven  hours ;  the  whole  of  the 
matters  expelled  from  the  stomach  and  bowels  not 
exceeding  three  pints,  and  of  a  light  brown  color. 
Spasms  of  the  voluntary  muscles  occur  in  this  stage, 
which  affect  the  abdominal  muscles,  the  calves  of  the 
legs,  the  thighs,  and  frequently  the  muscles  of  the 
upper  extremities  and  chest.  Occasionally  all  the 
voluntary  muscles  will  be  affected.  The  pulse  during 
this  stage  is  generally  less  frequent  than  in  health ; 
it  is  not  unusual  to  find  it  no  more  than  50  or  60 
beats  in  a  minute.  The  pulse  does  not  vary  much 
from  its  natural  fulness  until  the  disease  is  considera- 
bly advanced.  The  symptoms  of  this  period  may 
continue  from  one  to  twelve  hours.  When  the  disease 
is  about  to  terminate  favorably,  the  spasms  disappear, 
the  vomiting  ceases,  the  dejections  become  tinged 
with  bile,  and  perhaps  acquire  some  consistence,  or 
they  stop  entirely ;  in  which  event  the  patient  may 
have  no  evacuations  during  the  period  of  convales- 
cence, which  maybe  twenty-four  or  forty-eight  hours. 
In  some  instances,  the  patients  may  have  copious 
evacuations  from  the  alimentary  canal,  without  spasms ; 
these  are  called  the  Diarrhcuic  cases.  We  have  also 
the  Gastric  variety,  when  vomiting  is  the  prominent 
symptom  ;  also  the  Spasmodic  cases,  in  which  there 
may  be  no  evacuations  of  any  kind — only  cramps. 
These  designations  are  recognized  by  some  authors, 


AN    ESSAY   ON    EPIDEMIC    CHOLERA.  233 

and  are  convenient  in  description  ;  all  agreeing  in  one 
particular,  in  their  tendency  to  collapse,  if  not  soon 
relieved  by  appropriate  medical  treatment.  There  is 
a  class  of  cases  which  have  been  included  in  the 
designation  Cholera  sicca — dry  Cholera:  these  are 
the  instances  in  which  we  have  the  symptoms  of  col- 
lapse, without  its  having  been  preceded  by  any  eva- 
cuation or  other  precursory  symptom. 

Collapse  signifies  an  almost  total  suspension  of 
the  powers  of  organic  life,  not  necessarily  attended 
with  loss  of  consciousness  or  impairment  of  the 
mental  powers.  It  is  the  opposite  condition  to  coma, 
in  which  all  the  functions  of  organic  life  are  carried 
on,  while  the  functions  of  animal  life  are  totally  sus- 
pended ;  we  have  a  total  suspension  of  the  functions 
of  the  two  principal  secretory  organs  of  the  animal 
system,  viz  :  the  liver  and  the  kidneys,  two  of  the 
characteristic  symptoms  being  an  entire  absence  of 
bile  in  the  evacuations,  and  a  total  suppression  of 
urine,  so  that  the  patient  will  not  pass  the  smallest 
quantity  during  the  period  of  collapse.  The  other 
secretions  are  diminished,  if  not  altogether  suspend- 
ed ;  thus  though  there  may  be  the  greatest  suffering 
from  spasms  of  the  voluntary  muscles,  or  from  a  sen- 
sation of  internal  heat,  and  from  an  insatiable  thirst, 
the  patient  will  not  shed  tears.  There  is  an  appa- 
rent exception  to  the  absence  of  secretions,  in  the 
discharges  from  the  alimentary  canal ;  but  even  this" 
is  suspended  in  extreme  collapse.  The  functions  of 
respiration  and  circulation,  though  not  entirely  sus- 


234  APPENDIX. 


pended,  are  nevertheless  carried  on  in  an  extremely 
imperfect  manner  ;  the  principal  objects  of  these  func- 
tions, viz :  the  oxygenation  of  the  blood  and  the  main- 
tenance of  a  uniform  temperature,  being  but  par- 
tially accomplished ;  as  is  shown  by  the  blue  color  of 
the  surface,  by  the  coldness  of  air  expired  from  the 
lungs,  and  by  the  general  coldness  of  the  body.  We 
must,  however,  consider  that  the  mechanical  portion 
of  these  functions  is  carried  on  more  perfectly  than 
the  vital  or  chemical.  These  functions  are  not  whol- 
ly subservient  to  the  direction  of  the  forces  of  orga- 
nic life,  but  the  function  of  respiration  at  least,  is  to 
a  considerable  extent  under  the  direction  of  the  will. 
While  the  functions  of  organic  life  are  affected  in  so 
remarkable  a  degree,  we  have  those  of  animal  life  re- 
maining almost  entire.  The  sentient  faculties  remain 
in  many  cases  almost  until  respiration  ceases  ;  the 
patient  can  feel,  see,  hear,  smell  or  taste,  nearly  to 
the  last.  The  voice,  being  a  function  connected  with 
respiration,  is  weak  and  sometimes  scarcely  audible, 
partly  in  consequence  I  presume  of  the  diminished 
quantity  of  air  taken  into  and  expired  from  the  lungs. 
The  muscular  system  remains  in  great  measure  unim- 
paired, the  patient  being  capable  of  performing  many 
acts  of  voluntary  motion. 

In  complete  collapse,  as  seen  in  some  cases  of 
Asiatic  Cholera,  the  features  are  pinched  and  the 
eyes  appear  sunken ;  the  skin  is  of  a  bluish  color, 
the  whole  surface  being  covered  with  a  cold  clammy 
sweat,  imparting  a  sensation  of  icey  coldness  to  the 


AN    ESSAY    ON    EPIDEMIC    CHOLERA.  235 

touch,  the  hands  are  corrugated,  appearing  as  though 
they  had  been  soaked  in  water  for  some  time ;  hence 
this  appearance  has  been  called  the  "ivasher woman's 
hands:"  the  voice  is  peculiar,  so  that  it  has  been 
known  as  the  "  Vox  Cholerica  ;"  it  becomes  husky 
and  faint ;  the  breath  is  cold.  The  pulse  is  general- 
ly frequent,  small  and  quick,  sometimes  intermittent 
and  irregular.  In  many  cases  the  pulse  remains 
imperceptible  for  several  hours,  in  other  instances 
where  it  is  not  totally  imperceptible,  the  sensation 
which  it  imparts  to  the  touch  may  be  compared  to 
that  which  would  be  produced  if  the  finger  were 
placed  upon  one  point  of  an  exceedingly  fine  wire, 
tightly  drawn  between  two  fixed  points,  while  some- 
thing were  drawn  quickly  across  another  point  of  the 
wire,  producing  minute  vibrations.  This  I  think 
illustrates  the  pulse  of  collapse,  as  nearly  as  possi- 
ble. 

The  evacuations  from  the  stomach  and  bowels  be- 
come less  and  less  frequent,  as  the  symptoms  of  this 
stage  appear,  and  in  most  cases  cease  entirely  a  few 
hours  before  death,  in  which  in  a  majority  of  cases, 
collapse  terminates.  The  spasms  frequently  continue 
after  collapse  has  appeared,  though  they  very  generally 
cease  a  short  time  previous  to  death.  The  secretion 
of  urine,  which  becomes  diminished  in  the  stage  of 
full  development,  is  entirely  suppressed  in  collapse, 
and  in  post-mortem  examinations  the  bladder  is  uni- 
formly found  empty.  In  this  stage  an  insatiable 
thirst  in  many  cases  torments  the  patients,  they 


236  APPENDIX. 

taking  drink  frequently,  but  in  small  quantities  ;  and 
while  the  external  surface  is  cold  to  the  touch,  the 
patient  complains  of  an  internal  burning.  Among 
the  characteristic  symptoms  of  Cholera,  is  to  be  enu- 
merated the  stoical  indifference  which  the  patient 
manifests  in  regard  to  the  final  result  of  the  disease. 
This  apathy  exists  during  the  first  stage,  and  increa- 
ses with  the  progress  of  the  malady. 

The  period  of  collapse  lasts  from  two  to  twelve 
hours,  and  it  may  terminate  in  death,  or  be  succeeded 
by  reaction.  Among  the  symptoms  .from  which  we 
may  infer  that  reaction  is  about  being  established 
there  are :  a  return  of  the  natural  warmth  to  the 
surface,  and  the  pulse  reappearing  and  becoming  full 
and  regular.  A  very  important  symptom  is  the  re- 
turn of  the  secretion  of  urine.  The  breath,  which 
before  was  cold,  becomes  warm,  and  in  fact  all  the 
symptoms  which  constitute  collapse  disappear. 

It  frequently  happens  that  reaction  does  not  stop 
until  some  degree  of  febrile  action  is  set  up ;  and 
here  again  we  have  another  period  of  danger,  arising 
from  excessive  reaction.  In  this  period,  the  patient 
may  have  inflammation  or  congestion  of  any  of  the 
important  organs  of  life,  or  again,  it  may  be  followed 
by  continued  fever.  The  most  frequent  inflammations 
are  dysentery  and  inflammation  of  the  brain. 

In  the  foregoing  description  of  Cholera,  I  have 
spoken  of  it  as  though  it  consisted  of  three  clearly 
defined  stages  or  periods :  in  a  number  of  cases  we 
find  the  disease  running  its  course  with  as  much 


AM    iiSSAY    ON    KP.DEMIC    CHGLKRA  237 

regularity  as  the  previous  description  would  imply, 
but  in  a  larger  proportion  of  the  cases  which  occur, 
this  is  not  true,  the  symptoms  described  as  belonging 
to  the  several  periods  being  combined  in  every  va- 
riety. Thus  it  can  be  said  that  no  two  cases  are 
precisely  similar. 

The  results  of  post-mortem  examinations  have 
thrown  little  light  upon  the  nature  of  this  disease  ; 
as  but  few  of  the  lesions  observed  were  constant. 
The  only  appearances  which  were  constantly  observed 
in  autopsies  of  Cholera  patients,  were  more  or  less 
of  the  rice-water  and  ricey  matters  in  the  alimentary 
canal,  similar  in  appearance  to  that  which  had  pre- 
viously been  ejected,  and  a  thick  black  substance  re- 
sembling in  appearance  tar,  filling  the  veins,  and  the 
bladder  was  uniformly  found  empty  and  contracted. 

Spasmodic  movements  of  the  limbs  have  been  ob- 
served to  take  place  after  respiration  had  ceased. 
Instances  of  this  kind  are  probably  of  not  very  fre- 
quent occurrence,  as  very  little  mention  is  made  of 
them  in  works  upon  Cholera.  My  own  attention  was 
drawn  to  the  fact  by  the  following  .case  which  occurred 
in  New- York  on  the  29th  of  May.  1849,  about  fifteen 
days  after  the  first  appearance  of  the  epidemic  in  the 
city.  The  patient  was  the  wife  of  a  respectable  me- 
chanic, and  was  of  perfectly  temperate  habits ;  age 
40  years.  She  was  attacked  about  ten,  P.  M.,  May 
28th,  having  previously  partaken  of  radishes  for  her 
supper  that  evening,  which  seemed  to  have  been  the 

occasional  cause  of  her  sickness.     Symptoms :  rice- 
11* 


water  evacuations  per  anum ;  vomiting  of  a  serous 
and  slightly  milky  liquid,  with  pieces  of  radish, 
cramps  in  extremities,  chiefly  in  calves  and  thighs. 
Tongue  cold ;  urine  suppressed ;  eyes  upturned  and 
fixed  a  part  of  the  time  ;  tongue  covered  with  whitish 
coat,  which  afterwards  became  yellowish.  The  pulse 
was  feeble,  and  became  insensible  two  hours  before 
death.  Breath  cold ;  feet,  face  and  hands  cold  and 
moist,  except  palms,  which  retain  some  heat.  Epi- 
gastrium swollen,  painful  and  sensitive.  Died  about 
eleven  and  a  half,  A.  M.,  29th  inst.  After  respira- 
tion had  ceased  half  an  hour,  spasmodic  movements 
occurred  in  her  right  arm ;  her  fore-arm  became 
flexed  upon  her  arm ;  flexion  of  the  fingers  also  took 
place.  These  motions  were  repeated  a  number  of 
times,  leading  the  friends  to  suppose  that  life  was 
not  extinct,  and  causing  them  to  send  for  medical  as- 
sistance. Another  curious  phenomenon,  is  the  return 
of  warmth  to  the  surface,  and  its  continuance  for  a 
considerable  time  after  respiration  has  ceased.  The 
temperature  of  the  corpse,  which  previously  to  death 
was  externally  cold,  becomes,  in  many  cases  after 
respiration  has  ceased,  so  warm  as  to  impart  to  the 
touch  a  sensation  of  heat. 


APPENDIX  II. 


HOMOEOPATHIC   CHOLERA  HOSPITAL. 

As  the  Cholera  has  now  reappeared  in  New- York 
and  many  other  places,  the  republication  of  certain 
remarks,  made  on  the  above  subject  in  1849,  is  deemed 
seasonable  and  proper.  As  a  majority  of  the  medical 
profession  retain  the  same  prejudices,  the  friends  of 
humanity  and  justice,  here  and  elsewhere,  will  be  again 
liable  to  encounter  similar  obstacles,  in  carrying  out 
their  plans  for  the  relief  of  the  poor,  who  are  especi- 
ally liable  to  become  victims  of  this  pestilence. 

The  great  success  of  the  homoeopathic  treatment 
in  the  cholera  of  1849,  by  attenuated  medicines,  is 
now  extensively  known.  When  the  epidemic  had 
disappeared,  the  Board  of  Health  of  the  city  of  New- 
York,  through  its  Sanatary  Committee,  made  a  Re- 
port in  which  reasons  were  assigned  for  refusing  to 
establish  a  homoeopathic  cholera  hospital,  for  which  a 
petition  had  been  presented  by  hundreds  of  our  re- 
spectable citizens. 

Some  of  the  reasons  were  assigned  by  the  Sanatary 
Committee,  others  by  their  Medical  Counsel,  com- 
posed of  several  physicians  of  high  rank.  The  parts 


240  APPENDIX. 


referred  to  in  the  letter,  are  quot<*l  in  the  words  of 
the  authors. 

It  will  be  seen  that  (to  use  the  language  of  a  dis- 
tinguished writer)  ''  though  the  Board,  even  while 
thus  deciding,  profess  not  to  be  competent  to  decide, 
they  seem  to  consider  themselves  competent  to  sneer." 

The  Medical  Counsel,  in  their  report  to  the  Sana- 
tary  Committee,  say,  that 

"  By  intelligent  and  well-educated  physicians  ge- 
nerally, Homoeopathy  is  looked  upon  as  a  species  of 
empiricism.  It  is  neither  practised  by  them,  nor 
countenanced  by  them.  Concurring  entirely  with 
their  professional  brethren  on  this  subject,  the  under- 
signed conceive  that  the  public  authorities  of  our 
city  would  not  consult  either  their  own  dignity  or  the 
public  good,  by  lending  the  sanction  of  their  name  or 
influence  to  Homoeopathy  or  any  other  irregular  mode 
of  practice." 

The  Committee  say,  that 

"  In  adopting  this  report,  the  Sanatary  Committee 
do  not  wish  to  be  considered  as  expressing  any  opinion 
either  in  favor  or  against  what  is  commonly  denomi- 
nated Homoeopathy.  This  they  viewed  as  a  subject 
entirely  beyond  their  province." 

After  some  other  remarks,  they  end  by  saying, 

"  Taking  this  view  of  the  subject,  the  committee 
felt  it  to  be  their  duty  to  have  nothing  to  do  with 
medicine,  except  as  they  found  it  embodied  in  what 
is  understood  and  known  both  by  the  public,  as  well 
as  physicians,  as  the  regular  profession.  While  in 


HOMOEOPATHIC    CHOLERA    HOSPITAL.  241 


this  way  they  paid  all  suitable  respect  to  so  honor- 
able a  profession  as  that  of  medicine,  the  committee 
felt  that  they  did  no  injustice  to  those  who  suppose 
themselves  in  advance  of  the  age,  and  profess  them- 
selves gifted  with  superior  knowledge  and  wisdom." 

LETTER 

To  the  Sanatary  Committee  of  the  Board  of  Health 
of  the  City  of  New-  York : 

GENTLEMEN  : — In  the  report  of  your  proceedings 
recently  published,  you  assign  reasons  for  not  es- 
tablishing a  Homoeopathic  Cholera  Hospital.  Not- 
withstanding the  equivocal  compliment  which  you 
bestow  on  the  homceopathists,  as  "  those  who  sup- 
pose themselves  in  advance  of  the  age,  and  profess 
themselves  gifted  with  superior  knowledge  and  wis- 
dom," I  shall  assume  that  you  intended  "no  injus- 
tice" toward  either  of  the  two  great  medical  parties 
into  which  the  community,  as  well  as  the  regular  pro- 
fession, is  divided. 

The  regular  medical  profession  includes  all  those 
who  have  pursued  the  course  of  medical  studies  pre- 
scribed by  the  laws  of  the  State,  and  complied  with 
all  the  professional  requirements  of  the  medical  col- 
leges and  medical  societies  which  the  State  has  esta- 
blished. The  diplomas  held  by  the  homoeopathic 
physicians  of  New-York,  afford  proof  that  they  have 
passed  these  ordeals. 


242  APPENUiX. 

As    such   are   the  only  tests  of  professional  re- 
gularity recognised  under  this  or  any  civilized  go- 
vernment,   I   cannot  presume  that   you   "  suppose" 
yourselves  so  far  "  in  advance  of  the  age,  and  pro- 
fess" yourselves  "  gifted  with"  such  "  superior  know- 
ledge and  wisdom"  as  to  impose,  intentionally,  a  new 
test  not  recognised  by  those  laws  from  which  you 
derive  all  your  authority.     How  is  it,  then,  that  you 
refused  to  place  one  of  the  cholera  hospitals  under 
the  care  of  regular  homoeopathic  physicians,  on  the 
ground  that  "  the  committee  felt  it  to  be  their  duty 
to  have  nothing  to  do  with  medicine,  except  as  they 
found  it  embodied  in  what  is  understood  and  known, 
both  by  the  public  as  well  as  physicians,  as   the  re- 
gular profession  ?"     Is  it  possible  that  you  were  de- 
ceived by  a  mere  name,  which  some  physicians  have 
assumed  for  themselves,  and  persuaded  their  friends 
to  appropriate  to  them  ?     Regularity,  in  its  proper 
sense,  is  an  excellent  thing :  so  are  Catholicism  and 
democracy :  but  I  doubt  whether  you  have  all  re- 
solved to  have  nothing  to  do  with  religion,  except  as 
you  find  it  embodied  in  the  Catholic  church,  or  with 
politics,  except  as  you  find  it  embodied  in  the  demo- 
cratic party. 

You  must  mean,  either  that  the  homoeopathic  phy- 
sicians constitute  no  part  of  the  regular  profession, 
or  else  that  they  constitute  only  a  minority.  The 
first  position  I  have  shown  to  be  untenable.  In  con- 
sidering the  second,  I  assume  that  minorities  have 
rights,  on  which  no  agents  of  government  can  properly 


HOMCEOPATHIC    CHOLERA     HOSPITAL.  243 


trample.  During  a  pestilence,  the  homoeopathic  citi- 
zens of  New-York  can  justly  claim,  that  a  due  pro- 
portion of  what  they  have  contributed  to  the  funds 
of  the  city,  be  appropriated  to  the  use  of  a  homoeo- 
pathic hospital.  They  have  a  right  to  dictate  what 
provision  shall  be  made  for  the  treatment  of  the  in- 
digent and  stranger  of  their  own  medical  faith,  so  far 
as  this  can  be  conceded  without  infringing  the  rights 
of  others.  In  regard  to  this  last  point,  you  were  not 
requested  to  refrain  from  establishing  as  many  alloeo- 
pathic  hospitals  as  you  deemed  expedient,  nor  to 
compel  any  patient  to  enter  the  homoeopathic. 

The  statement  of  the  main  objection  which  your 
medical  counsel  urged  against  Homoeopathy  may  be 
ambiguous ;  but  it  is  susceptible  of  only  two  con- 
structions :  one  is  that  "  it  is  neither  practised"  "nor 
countenanced  by';  a  majority  of  "  intelligent  and  well- 
educated  physicians."  This  proves  no  more  than  the 
equally  notorious  fact,  that  it  is  neither  practised  nor 
countenanced  by  the  majority  of  stupid  and  unedu- 
cated physicians.  Alloeopathy  has  more  great  men 
and  more  small  ones  ;  for  the  same  reason  that  white 
sheep  have  more  wool  than  black  ones. 

The  only  other  meaning  of  which  the  statement 
of  the  "  counsel",  is  susceptible,  is,  that  Homoeopathy 
"  is  neither  practised"  "  nor  countenanced  by"  any 
intelligent  and  well-educated  physicians.  Is  this  the 
assertion  of  the  medical  counsel,  a  majority  (i.  e.  two) 
of  whose  members  are  medical  professors,  who 
are  annually  recommending  homoeopathic  medical 


244  APPENDIX. 

students  as  qualified  to  receive  the  degree  of  doctor 
of  medicine  ?  From  these  and  similar  allosopathic 
professors,  the  homoeopathic  physicians  now  practis- 
ing have  received  their  credentials.  When  a  pro- 
fessor affirms  that  his  own  certificate  is  false,  to 
which  of  his  statements  shall  we  give  credence  ?  The 
case  reminds  us  of  the  problem  which  exercised  the 
sophists.  When  a  man  says,  I  lie,  does  he  lie  or 
does  he  speak  the  truth? 

Neither  the  committee  nor  their  counsel  have  at- 
tempted to  refute  the  statistics  hy  which  the  petition 
was  sustained,  nor  to  deny  that  Homooeopathy  af- 
fords the  best  method  of  curing  the  sick,  however 
much  the  "public  authorities"  might,  by  rejecting  it, 
"consult  their  own  dignity,"  and  thus,  indirectly, 
"the  public  good."  Of  their  objections,  I  am  not 
able  to  perceive  any  which  are  not  substantially  in- 
cluded in  those  which  I  have  answered.  If  there  is 
an  appearance  of  mystification  or  muddiness  in  the 
whole  train  of  their  reasoning,  I  have  too  much  re- 
spect for  them  to  attribute  it  to  anything  else  than 
the  unavoidable  difficulties  attending  the  defence  of 
a  weak  cause. 

B.  F.  JOSLIN,  M.D. 
NEW- YORK,  Nov.  17, 1849. 


INDEX. 


A. 

Page 
Acute  cholera,  cases  of 170 

its  symptoms  and  treatment 120 

^Etiology,  especially  with  reference  to  the  predisposing  or  occa- 
sional causes  of  cholera 30 

Ages,  relative  liability  to  an  attack  at  different 223 

mortality  at  different 226 

Alcohol,  predisposes  to  cholera 38 

Animal  food,  during  the  epidemic 40 

Ancient  and  modern  epidemic  cholera  identical 216 

Appendix  1 215 

II 239 

Atmospheric  heat,  a  cause  of  cholera 32 

Attenuated  Camphor  useful 107,  124,  148,  157,  160,  180 

Auxiliary  cholera  repertory 199 

.     B. 

Bathing,  its  uses  and  abuses 36 

Becoming  chilled  by  cold  air,  or  bathing 35 

Blood  in  asphyxia,  original  observations  and  experiments  on,  24,  28 

its  color  and  composition  in  cholera 18 

Blueness  of  the  skin,  in  choleroid 141,  180 

..  „       ..      remedies  for,  in  cholera 195 

Board  of  Health  in  1849. .  78,  240 


246 


INDEX. 


c. 

Page 

Camphor,  effects  of  high  potencies  of 107 

how  to  be  used  for  children 125 

rules  for  its  administration 103 

size  and  repetition  of  the  dose  of 103 

Case  of  acute  choleroid  in  1854,  with  its  treatment 180 

dry  cholera,  with  its  treatment 168 

febrile  cholera,  with  its  treatment 179 

gastro-enteric  cholera,  with  its  treatment 176 

Cases  in  New-York  in  1854 153 

of  acute  cholera,  with  their  treatment 170 

of  choleroid  disease,  with  their  treatment 138 

of  diarrhoeic  cholera,  with  their  treatment 144 

of  dysenteric  cholera,  with  their  treatment 176 

of  gastric  cholera,  with  their  treatment 160 

of  spasmodic  cholera,  with  their  treatment 162 

Causes  of  cholera 30 

of  cholera  recapitulated 49 

Characteristic  of  cholera 13 

Cholera  infantum,  remedies  for 212 

in  1832,  history  of  treatment  of 70 

—  1849,  cases  and  their  treatment 144 

—      --     history  of  treatment  of 76 

—  1854,  cases  and  their  treatment 153 

—      —     in  Honduras 97 

Cholerine 100 

Choleroid,   cases  of 188 

Choleroid,    what  it  is 137 

Circular  issued  by  homoeopathic  physicians 87 

Cleanliness,  neglect  of 45 

Cold  bathing,  reason  why  under  some  circumstances,  it  is  a  pre- 
disposing cause 35 

Collapse,  its  treatment 1 30 

Composition  and  consistence  of  the  faces 207 

Contagion  and  poison  quantitatively  considered 51,  55 


INDEX.  247 

Page 
Contagion  of  cholera 50,  220 

Contagiousness  of  cholera,   how  destroyed  by  dilution 53 

Contents,  table  of 3 

Cramps  in  Cholera,  how  treated 118 

Crowded  or  insufficiently  ventilated  rooms 44 

D. 

Dark  color  of  the  blood  in  cholera 18 

Depressing  passions,  how  they  render  the  system  more  liable 

to  cholera 38 

Diarrhoeic  cholera,  symptoms  and  treatment 113 

Dilution,  its  influence  on  infection 53 

Dysentery,   remedies  for 213 

Domestic  and  professional  treatment  of  cholera  at  its  onset  in 

any  form 102 

and  professional  treatment  of  premonitory  symptoms. .  100 

Dose  of  cholera,  is  one  of  the  elements  in  the  problem  of  its  in- 

fectiousness 55 

Doses  of  medicine,  repetition  of 103,  110 

Dry  cholera,  how  distinguished 119 

how  treated 120 

Dysenteric  cholera,  its  symptoms 123 

—      its  treatment 125 

E. 

Early  history  of  cholera 215 

treatment  of  cholera 100 

Epidemic  and  sporadic,  remarks  on  the  terms 135 

cholera  and  cholera  morbus,  not  identical 13,  215 

Errors  that  prevail  in  regard  to  contagion 50 

Essential  cause  of  cholera,  imperceptible  except  by  its  effects. .     30 

—    —    —       its  effects  before  and  after  an  epidemic  31 

Etiology  of  cholera 30 

Exercise,  when  violent,  is  a  predisposing  cause 38 

Explanation  of  the  auxiliary  cholera  repertory 199 

of  the  cholera  repertory 181 


248  INDEX. 

F. 

Page 

Fatigue,  a  predisposing  cause  of  cholera ". 38 

Fasting  during  the  epidemic 38 

Febrile  cholera,  its  symptoms '  126 

—          its  treatment 126 

Food,  the  kinds  of,  forbidden.' 61,  63 

Forms  in  which  cholera  appears 109 

G. 

Gastric  cholera,  its  symptoms  and  treatment 116 

G  astro-enteric  cholera,  its  symptoms 122 

—        —        its  treatment 123 

General  average  of  the  results  of  homoeopathic  treatment  in 

cholera , 94 

Generalization  of  the  causes  of  cholera 30 

Groups  of  diarrhoeic  symptoms  in  cholera,  with  their  remedies. .  190 

of  symptoms  in  diarrhoea  with  their  remedies 210 

H. 

Head  symptoms  in  cholera,  remedies  for 184 

Health,  how  to  preserve 61 

Heat,  effect  of. 32 

High  potencies  of  camphor,  effects  of 107 

—     temperature,  effects  of 32 

History  of  homoeopathic  and  allopathic  treatment  of  cholera. . .     67 

Homoeopathy  in  cholera,  proofs  of  its  relative  success 67 

Honduras,  cholera  in 97 

Hospital,  homoeopathic  for  cholera  patients 84,  240 

Hygiene 61 

Hygienic  rules ; . . . .     62 

I. 
Indefiniteness  of  the  usual  statement  of  the    problem  of  the 

infectiousness  of  cholera 52 

Indigestion,  a  cause  of  cholera 43 

Infection,  the  true  doctrine  of 50 


INDEX.  249 

Page 
Influence  of  degrees  of  dilution  of  the  poison 53 

Intestinal  symptoms  in  cholera,  repertory  for 189 

—        with  or  without  cholera,  repertory  for 206 

L. 
Law  of  cure 109 

M. 

Management  of  a  cholera  patient,  rules  for  the 108 

Mental  symptoms,  in  cholera,  remedies  for 183 

N. 

Nature  of  cholera 13 

Neglect  of  personal  cleanliness 45 

Night,  one  reason  why  it  is  a  predisposing  cause 37 

0. 

Occasional  causes  of  cholera 32 

Oppression  of  the  digestive  organs 43 

Over-eating  an  occasional  cause 43 

P. 

Passions,  predispose  to  cholera 38 

Pathology  of  cholera 18 

Per  centage  of  deaths  in  New- York,  remarks  on 83 

—    —    of  deaths  under  homoeopathy  and  allopathy  in  1832  70 

—         —       —  1849  76 

Physiology  of  respiration 16 

Poisons  are  such  by  dose,  not  in  essence 55 

Popular  and  medical  errors  in  regard  to  infection  or  contagion .  50 

Powders,  plain  directions  as  to  the  best  mode  of  taking  them. .  102 

Predisposing  causes  of  cholera 32 

Prevention  of  cholera,  by  what  medicines 65 

—        —       by  what  regimen 62 

Preventive  medicines,  what,  and  how  to  be  used 65 

Progress  of  cholera  epidemics 60 

Proportion  of,  of  cases,  cured  in   1832 70 

—        —     —   1849  .  .76 


250  INDEX. 

Q. 

Page 
Quarantine,  the  effect  of 60 

R. 

Remedies  for  cholera  infantum 212 

Remedies  for  cholera  with  affections  of  the  abdomen 189 

—  chest 193 

eyes 184 

—  —  —  face 185 

head 184 

—  —  —  limbs 194 

—  —  —  mind 183 

— —  —  —  —  pulse 197 

skin 195 

—  —  —  tongue 186 

—  —  —  urine 192 

—  —  voice 193 

Remedies  for  cholera  with  cramps 194,  198 

—      —     thirst  and  nausea 187 

—  —     diarrhoea 190 

— —  —      —      nausea  and  thirst 187 

—  —     pains  in  the  stomach 188 

—  —     perspiration 197 

— —  —  —     spasms 194,  198 

— —  —  —     vomiting. . . .  '.   187 

Remedies  for  diarrhoea  from  certain  causes 208 

— —  —      with  or  without  cholera 206 

—       —     other  symptoms 210 

—      —     stools  of   certain  colors 206 

—      —      stools  of  certain  odor 207 

for  dysentery 213 

—  stomach  pains 204 

—  vomiting  according  to  its  causes 202 

—         —  —  —     character 200 

—         —             —          to  the  symptoms  which  ac- 
company it 203 

for  vomiting,  with  or  without  cholera 200 


INDEX.  251 

Page 

Repertories,  explanation  of  the  mode  of  using 181 

Repertory  for  cholera  especially 181 

for  vomiting  and  diarrhoea,  with  or  without  cholera. .  199 

Repetition  of  doses 103,  110 

Respiration,  physiology  of 16 

—     applied  to  the  pathology  of  cholera  18 

Results  of  homoeopathic  treatment,  summary  of 94 

Rooms  for  cholera  patients,  how  to  select  and  use 54 

Rules  for  the  preservation  of  health  during  the  epidemic 62 

S. 

Stages  of  cholera 128 

Statistics  of  cholera,  homoeopathic  and  allopathic 67 

Spasmodic  cholera,  how  treated 118 

Susceptibility,  cateris  paribus,  determines  whether  the  disease 

shall  be  taken 58 

Symptoms  and  treatment  of  the  usual  varieties  of  cholera 113 

T. 

Tables  illustrating  the  relative  mortality  at  different  ages 227 

—      —      number  of  attacks    at  different 

ages 224 

Table  of  contents 3 

Treatment,  during  collapse 130 

during  convalescence  from  cholera 134 

of  acute  cholera 121 

of  affections  succeeding  reaction  from  cholera 131 

of  cholera  by  families  at  its  commencement 102 

—  in  the  forming  or  choleroid  stage 100 

when  fully  developed 102,  129 

—  when  it  begins  to  be  developed 102 

—  with  dysentery 125 

—  with  vomiting  and  purging 123,  187,  190 

of  diarrhoeic  cholera 115,  190 

of  dry  cholera 120 

of  febrile  cholera..  .126 


£52 


INDEX. 


f  i'age 
Treatment  of  gastric  cholera 1 17,  187 

of  premonitory  symptoms 100 

of  spasmodic  cholera 118,  194,  198 

——      of  the  different  varieties  of  cholera 113 

— —      of  vomiting  in  cholera 117,  187 

V. 

Varieties  of  cholera,  their  symptoms  and  treatment 113 

Ventilation,  the  want  of,  operates  in  two  ways 44 

Vomiting  and  purging  in  cholera,  how  treated 123,  187,  190 

in  cholera,  how  treated 117 

—      remedies  for  the  different  kinds  of,  in  cholera 187 

—  —  —          —        in  general 200 


Date  Due 


Jill  <? 


CAT.    NO.    23    233  PRINTED    IN    U.S.A. 


000510158 


WC262 
J83h 
1851* 
Joslin. 

Homoeopathic  treatment  of 

epidemic  cholera 


WC262 
J83h 


Joslin. 

Homoeopathic  treatment  of 
epidemic  cholera 


